TY - JOUR
T1 - Anatomical predictors for suture-based closure of the patent foramen ovale
T2 - A multicenter experience
AU - Witte, Lars S.
AU - Renkens, Mick P. L.
AU - Gąsecka, Aleksandra
AU - el Bouziani, Abdelhak
AU - de Winter, Robbert J.
AU - Tijssen, Jan G. P.
AU - Stella, Pieter R.
AU - Leibundgut, Gregor
AU - Voskuil, Michiel
N1 - Publisher Copyright: © 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Background: NobleStitch EL is a novel suture-based technique used for patent foramen ovale (PFO) closure and an alternative to traditional double-disc devices without the need for antithrombotic therapy. However, successful closure rates are still unknown, and certain anatomies may be unfavorable for successful closure. Aims: We assessed the efficacy of the NobleStitch EL and sought to identify patient-related anatomical features associated with successful suture-based closure. Methods: We included 55 patients who underwent PFO closure with the NobleStitch EL in The Netherlands and Switzerland. Successful closure was defined as residual right-to-left shunt grade ≤1 with Valsalva maneuver at a cardiac ultrasound. Predefined possible anatomical determinants for effective closure included PFO length, atrial septal aneurysm, PFO entry- and exit diameter. Results: Successful closure was achieved in 33 patients (60%). The PFO length was shorter in patients with successful closure compared to unsuccessful closure with a median length of 9.6 mm (IQR 8.0–15.0) versus 13.3 mm (IQR 11.4–18.6) on preprocedural ultrasound (p = 0.041) and 9.9 mm (IQR 8.0–13.1) versus 12.5 mm (IQR 9.7–15.4) on angiography (p = 0.049). Additionally, the PFO exit diameter and PFO volume were smaller in patients with successful closure than unsuccessful closure, with a mean diameter of 7.0 ± 3.1 mm versus 9.5 ± 3.8 mm (p = 0.015) and a median volume of 381 mm3 (IQR 286–894) versus 985 mm3 (IQR 572–1550) (p = 0.016). Conclusion: In our study cohort, the successful PFO closure rate using NobleStitch EL was relatively low (60%). With this alternative procedure, patients with a small PFO driven by a short PFO tunnel length and small exit diameter seem to be eligible for successful suture-based closure.
AB - Background: NobleStitch EL is a novel suture-based technique used for patent foramen ovale (PFO) closure and an alternative to traditional double-disc devices without the need for antithrombotic therapy. However, successful closure rates are still unknown, and certain anatomies may be unfavorable for successful closure. Aims: We assessed the efficacy of the NobleStitch EL and sought to identify patient-related anatomical features associated with successful suture-based closure. Methods: We included 55 patients who underwent PFO closure with the NobleStitch EL in The Netherlands and Switzerland. Successful closure was defined as residual right-to-left shunt grade ≤1 with Valsalva maneuver at a cardiac ultrasound. Predefined possible anatomical determinants for effective closure included PFO length, atrial septal aneurysm, PFO entry- and exit diameter. Results: Successful closure was achieved in 33 patients (60%). The PFO length was shorter in patients with successful closure compared to unsuccessful closure with a median length of 9.6 mm (IQR 8.0–15.0) versus 13.3 mm (IQR 11.4–18.6) on preprocedural ultrasound (p = 0.041) and 9.9 mm (IQR 8.0–13.1) versus 12.5 mm (IQR 9.7–15.4) on angiography (p = 0.049). Additionally, the PFO exit diameter and PFO volume were smaller in patients with successful closure than unsuccessful closure, with a mean diameter of 7.0 ± 3.1 mm versus 9.5 ± 3.8 mm (p = 0.015) and a median volume of 381 mm3 (IQR 286–894) versus 985 mm3 (IQR 572–1550) (p = 0.016). Conclusion: In our study cohort, the successful PFO closure rate using NobleStitch EL was relatively low (60%). With this alternative procedure, patients with a small PFO driven by a short PFO tunnel length and small exit diameter seem to be eligible for successful suture-based closure.
KW - NobleStitch EL procedure
KW - PFO closure
KW - cryptogenic stroke
KW - heartstitch
KW - patent foramen ovale
UR - http://www.scopus.com/inward/record.url?scp=85160069218&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ccd.30691
DO - https://doi.org/10.1002/ccd.30691
M3 - Article
C2 - 37221985
SN - 1522-1946
VL - 102
SP - 273
EP - 280
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 2
ER -