PMID- 23871675
OWN - NLM
STAT- MEDLINE
DCOM- 20131203
LR  - 20161125
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 112
IP  - 8
DP  - 2013 Oct 15
TI  - Effectiveness of percutaneous closure of patent foramen ovale for hypoxemia.
PG  - 1258-62
LID - S0002-9149(13)01448-3 [pii]
LID - 10.1016/j.amjcard.2013.06.022 [doi]
AB  - The aim of this study was to evaluate the ability of percutaneous patent foramen 
      ovale (PFO) closure to improve systemic hypoxemia. Although PFO-mediated 
      right-to-left shunt (RTLS) is associated with hypoxemia, the ability of 
      percutaneous closure to ameliorate hypoxemia is unknown. Between 2004 and 2009, 
      97 patients who underwent PFO closure for systemic hypoxemia and dyspnea that was 
      disproportionate to underlying lung disease were included for evaluation. All 
      patients exhibited PFO-mediated RTLS as determined by agitated saline 
      echocardiography. Procedural success was defined as implantation of a device 
      without major complications and mild or no residual shunt at 6 months. Clinical 
      success was defined as a composite of an improvement in New York Heart 
      Association (NYHA) functional class, reduction of dyspnea symptoms, or decreased 
      oxygen requirement. Procedural success was achieved in 96 of 97 (99%), and 
      clinical success was achieved in 68 of 97 (70%). The presence of any moderate or 
      severe interatrial shunt by agitated saline study (odds ratio [OR] = 4.7; p 
      <0.024), NYHA class at referral (OR = 2.9; p <0.0087), and 10-year increase in 
      age (OR = 1.8; p <0.0017) increased likelihood of clinical success. In contrast, 
      a pulmonary comorbidity (OR = 0.18; p <0.005) and male gender (OR = 0.30; p 
      <0.017) decreased the likelihood of success. In conclusion, based on the largest 
      single-center experience of patients referred for PFO closure for systemic 
      hypoxemia, PFO closure was a mechanically effective procedure with an associated 
      improvement in echocardiographic evidence of RTLS, NYHA functional class, and 
      oxygen requirement.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - Fenster, Brett E
AU  - Fenster BE
AD  - Division of Cardiology, National Jewish Health, Denver, Colorado. Electronic 
      address: fensterb@njhealth.org.
FAU - Nguyen, Bryant H
AU  - Nguyen BH
FAU - Buckner, J Kern
AU  - Buckner JK
FAU - Freeman, Andrew M
AU  - Freeman AM
FAU - Carroll, John D
AU  - Carroll JD
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20130719
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Cardiac Catheterization/*methods
MH  - Cardiac Surgical Procedures/*methods
MH  - Echocardiography, Transesophageal
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - Foramen Ovale, Patent/complications/diagnostic imaging/*surgery
MH  - Humans
MH  - Hypoxia/blood/etiology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Oxygen/*blood
MH  - *Prostheses and Implants
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2013/07/23 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/07/23 06:00
PHST- 2013/04/04 00:00 [received]
PHST- 2013/06/11 00:00 [revised]
PHST- 2013/06/11 00:00 [accepted]
PHST- 2013/07/23 06:00 [entrez]
PHST- 2013/07/23 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - S0002-9149(13)01448-3 [pii]
AID - 10.1016/j.amjcard.2013.06.022 [doi]
PST - ppublish
SO  - Am J Cardiol. 2013 Oct 15;112(8):1258-62. doi: 10.1016/j.amjcard.2013.06.022. 
      Epub 2013 Jul 19.