Foramen Ovale, Patent – ABC CARDIOL

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Review Article

The Role of Echocardiography in the Assessment of the Interatrial Septum and Patent Foramen Ovale as an Emboligenic Source

Angele Azevedo Alves Mattoso et al. Joberto Pinheiro Sena Viviane Tiemi Hotta

Abstract

Atrial septal defects (ASD) account for approximately 6%-10% of congenital heart defects, with an incidence of 1 in 1,500 live births.¹ Patent foramen ovale (PFO) is more common and is present in more than 20%-25% of adults.² Clinical syndromes associated with ASD and PFO are variable, and their implications are targeted by pediatric and adult medicine, neurology, and surgery.

Additional interest in the anatomy of the interatrial septum (IAS) has increased substantially over the last two decades. Additionally, percutaneous procedures involving left-sided structural heart disease and electrophysiological procedures have evolved considerably. Ideally, these catheter-based interventions require a direct route to the left atrium (LA) through the IAS, with a full understanding of its anatomy. Also, sophisticated and noninvasive imaging technologies such as two-dimensional transesophageal echocardiography (2D-TEE) and three-dimensional transesophageal echocardiography (3D-TEE), cardiac magnetic resonance imaging (CMR), and computed tomography (CT) have evolved considerably, providing anatomical details of cardiac structures visualized in 2D and 3D format and being key for the diagnosis and treatment of patients with heart diseases.

Therefore, assessing the anatomy of the IAS and any abnormalities requires a standardized and systematic approach, integrating diagnostic modalities and enabling adequate and consistent evaluation for both surgical and transcatheter therapies.

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ABCIC

Case Report

Noblestitch Failure After Percutaneous Patent Foramen Ovale Closure in a Case Of Platypnea-Orthodeoxia Syndrome: Is this Device Suitable for All Patients?

Ana Rita Moura et al. Mariana Silva Alberto Rodrigues João Carlos Silva … José Ribeiro Daniel Caeiro Jorge Casanova Ricardo Fontes-Carvalho

Introduction

Patent foramen ovale (PFO) is a common congenital cardiac lesion corresponding to a normal fetal interatrial communication that typically closes after birth with the fusion of the atrial septum primum to the septum secundum . When the foramen ovale persists, it is usually asymptomatic and benign, with no need for treatment. In rare cases, it can be implicated in the pathogenesis of some medical conditions, such as platypnea-orthodeoxia syndrome (POS). In this context, PFO closure may be indicated.

Several occluder devices, traditionally based on a double-disc design, have shown that percutaneous PFO closure is possible. Despite the proven efficacy, their use is not technically feasible for some patients. In addition, they have the potential to cause some complications. NobleStitch EL (NS) is an alternative percutaneous PFO closure technique available in Europe, European Commission (EC) marked for cardiovascular suturing and PFO closure, and in the US, with Food and Drug Administration (FDA) clearance for vascular and cardiovascular suturing. It consists of a “deviceless” system with two dedicated suture delivery catheters. ^, To date, the experience with the NS device is limited, and we still lack information about its failure determinants, which could help select patients. ^–

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ABC

Research Letter

An Unusual Cause of Hypoxemia after Orthopedic Surgery on an Elderly Patient

Pedro Carvalho et al. Daniela Meireles José Luís Martins Marco Costa Ana Briosa Neves

Introduction

Various conditions can cause post-operative hypoxemia, especially in elderly patients. However, a new symptomatic cardiac shunt is a very rare and unexpected complication in this setting. This study presents a case of refractory hypoxemia after orthopedic surgery due to right-to-left (R-L) shunt via a patent foramen ovale (PFO).

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Image

An Unusual Case of Acute Myocardial Infarction

Hugo Antunes et al. Inês Almeida Júlio Gil Luisa Gonçalves Gonçalves Miguel Correia

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The Role of Echocardiography in the Assessment of the Interatrial Septum and Patent Foramen Ovale as an Emboligenic Source

Abstract

Noblestitch Failure After Percutaneous Patent Foramen Ovale Closure in a Case Of Platypnea-Orthodeoxia Syndrome: Is this Device Suitable for All Patients?

Introduction

An Unusual Cause of Hypoxemia after Orthopedic Surgery on an Elderly Patient

Introduction

An Unusual Case of Acute Myocardial Infarction

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