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OBJECTIVE In recent years, percutaneous closure of a patent foramen ovale (PFO) has gained widespread use. This study is an evaluation of the safety and efficacy of the Figulla and Amplatzer devices for PFO closure, including long-term follow-up results. METHODS A total of 305 patients (43.6% male; mean age: 43.25±10.98 years) who underwent percutaneous PFO closure between 2003 and 2019 were enrolled. The Risk of Paradoxical Embolism (RoPE) score was calculated to predict the recurrence risk of cerebrovascular events due to PFO. Transthoracic echocardiography was used during the procedure. RESULTS The devices were successfully implanted in all patients. The in-hospital periprocedural complications recorded were atrial fibrillation in 1 patient (0.3%), supraventricular tachycardia in 1 patient (0.3%), and femoral hematoma in 3 patients (1%). The procedure time and fluoroscopy time was 21.92±2.93 minutes and 2.19±0.24 minutes, respectively. Recurrent ischemic stroke or transient ischemic attack (TIA) was observed in 7 (2.2%) patients during the median 85.77 months (25th-75th percentile: 10.21-108.00 months) follow-up. The RoPE score was significantly lower in patients with recurrent ischemic cerebral event (stroke or TIA) compared with asymptomatic patients (p

Objectives: In this study, we aimed to evaluate the effect of percutaneous closure of patent foramen ovale (PFO) on the recurrence of stroke and new cardiac arrhythmia using magnetic resonance imaging (MRI) and Holter monitoring. Study design: Patients with PFO had >1 previous stroke or transient ischemic attack documented with MRI in the first event. PFO with right to left shunt was detected by transesophageal echocardiography (TEE) and transcranial Doppler ultrasound. MRI examinations were performed on patients before and one year after PFO closure was applied. A twenty-four hour Holter monitoring was performed in all patients within 1 month before and 6 months after the procedure. Results: Percutaneous PFO closure was performed on 47 patients (25 female, mean age: 38.7 years) who had cerebral ischemic events detected by MRI. A year after the procedure, TEE showed that there was no residual interatrial right-to-left shunting. After a 14 month follow-up, no new cerebrovascular event and no new lesion on MRI were recorded. The incidence of arrhythmia did not increase significantly after the procedure on Holter monitoring (p=0.917). Conclusion: One-year clinical and MRI follow-up study of patients with cerebral ischemic events and percutaneous closure of PFO showed no recurrent event and no significant complication associated with the procedure. In addition, Holter monitorization demonstrated that the procedure did not increase the incidence of arrhythmias compared with pre-procedural monitoring.

Brugada syndrome is an inherited cardiac arrhythmia condition characterized by coved-type ST elevation and J point elevation of at least 2 mm in at least 2 of the right precordial electrocardiogram (ECG) leads (V1–3). An increasing number of noncardiac agents, including psychotropic and anesthetic drugs, have been shown to induce a characteristic Brugada ECG pattern, predisposing the patient to fatal ventricular arrhythmias. However, there are scarce data regarding the clinical significance. In this case series, a typical Brugada pattern was unmasked by lithium, valproic acid, and thiocolchicoside; however, the clinical scenario was different in all 3 cases, ranging from an asymptomatic patient to sudden cardiac arrest.

Objectives We evaluated our paclitaxel-eluting stent (Genius TAXCOR I) implantations and follow-up results in patients with coronary artery disease. Study design The study included 101 patients (75 men, 26 women; mean age 60±10 years) who underwent elective paclitaxel-eluting stent deployment for de novo native coronary artery lesions. Sixteen patients received two stents. Lesion types were as follows: type A (23.9%), type B1 (29.1%), type B2 (32.5%), and type C (14.5%). Twelve lesions (10.3%) exhibited mild tortuosity, 32 (27.4%) had mild calcification, 12 had (10.3%) an angulation of more than 45 degrees, while eight (7.7%) had thrombus. Following stent implantation, the patients were examined at 1, 6, and 12 months, and annually thereafter. The mean follow-up period was 48.9±5.7 months (range 35 to 60 months). Results Stent implantation was successful in all the patients. The mean diameter stenosis was 82.8±9.9%, the mean stent diameter was 3.1±0.6 mm, and the mean stent length was 16.0±5.2 mm. During the follow-up period, 46 patients (45.5%) required coronary angiography, of which eight (17.4%) received target vessel revascularization, and four (8.7%) received target lesion revascularization. One patient (1.0%) died from sudden cardiac death. Conclusion The clinical and angiographic follow-up results of this study involving relatively low- and intermediate-risk patients indicate that the use of the Genius TAXCOR I stents is effective and beneficial for the prevention of stent thrombosis and restenosis.

OBJECTIVES: We evaluated short- and mid-term results of percutaneous closure of atrial septal defects (ASD) and patent foramen ovale (PFO) using various closure devices. STUDY DESIGN: The study included 278 patients (128 men, 150 women; mean age 39±12 years; range 17 to 66 years) who underwent percutaneous closure of secundum ASD (n=134) or PFO (n=144). All the patients were assessed by transthoracic (TTE) and transesophageal (TEE) echocardiography before the procedure. Percutaneous closure was performed with the Amplatzer (n=180), Occlutech Figulla (n=92) or BioSTAR (n=6) devices. Closure of ASDs was performed under general anesthesia with TEE guidance, and closure of PFOs was performed under local anesthesia with TTE guidance. Follow-up controls were at 1, 6, and 12 months, and annually thereafter. The mean follow-up period was 35.1 ± 24.6 months for ASD cases, and 24.9 ± 15.5 months for PFO cases. RESULTS: The mean device size was 20.2 ± 5.6 mm for ASD cases and 24 ± 2.9 mm for PFO cases. The mean procedural and fluoroscopy times were 28.4 ± 6.1 min and 4.9 ± 2.1 min for ASD closure, and 18.2 ± 5.3 min and 3.6 ± 1.2 min for PFO closure, respectively. Procedural device embolization occurred in only one patient. No recurrent embolic events occurred after PFO closure, and no residual shunts were seen after ASD closure. Device thrombosis developed in two patients during the procedure and in one patient at one-year follow-up. CONCLUSION: Percutaneous closure of secundum ASDs and PFOs using the Amplatzer, Occlutech Figulla, and BioSTAR devices is an effective and safe treatment option.