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“PFO Closure: anatomical variants and implications for choice of procedure, success rates and complications” LM Shapiro. PowerPoint Presentation
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“PFO Closure: anatomical variants and implications for choice of procedure, success rates and complications” LM Shapiro. Papworth Hospital, Cambridge. NO CONFLICT OF INTEREST TO DECLARE . “PFO Closure: What are we trying to achieve LM Shapiro. “PFO Closure: What are we trying to achieve

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slide1
“PFO Closure: anatomical variants and implications for choice of procedure, success rates and complications”
  • LM Shapiro. Papworth Hospital, Cambridge
slide3
“PFO Closure:
  • What are we trying to achieve
  • LM Shapiro
slide4
“PFO Closure:
  • What are we trying to achieve

complete closure

  • LM Shapiro
assessment of pfo
ASSESSMENT OF PFO
  • Characterisation
    • Tunnel length / height / width
    • Flap separation / adhesion –
    • RA/LA edge, body
    • Flap retraction –
    • spontaneous / potential
    • Tunnel openings
    • “PFD (patent foramen defect)”– ASD structurally merged with PFO or PFO with functional ASD
slide9

Papworth Hospital

2005 to 2008

241 consecutive pfo closures (271 devices)

No late complication

3 balloon morphologies
3 balloon morphologies.

? LONG

TUNNEL

SHORT

TUNNEL

? SHORT

TUNNEL

LONG

TUNNEL

narrow partial fixed split long tunnel narrow ra opening shortest tunnel segment 12 5mm
Narrow partial fixed split, long tunnel, narrow RA openingShortest tunnel segment 12.5mm

Posterosuperior

Anterosuperior

papworth hospital

Conclusion

No one device fits all defects

Complete closure is necessary for stroke prevention

Echo Pfo characteristics determine appropriate device

Papworth Hospital

papworth hospital1

Conclusion

No one device fits all defects

Complete closure is necessary for stroke prevention

Echo Pfo characteristics determine appropriate device

Papworth Hospital

flap attachment
Flap attachment

Flap attachment point, marked by small indent of LA wall

slide23

Partial Split-level PFO.Apposition at RA edge only. fixed tunnel 1cm. LA edge tethered into LA, may not retract device traction to shorten tunnel much