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Article ; Online: LEFT ATRIAL APPENDAGE CLOSURE IN PATIENTS WITH MECHANICAL MITRAL VALVE PROSTHESIS: A MULTICENTER ITALIAN PILOT STUDY.

Preda, Alberto / Margonato, Davide / Gaspardone, Carlo / Rizza, Vincenzo / Vella, Ciro / Rampa, Lorenzo / Marzi, Alessandra / Guarracini, Fabrizio / Della Bella, Paolo / Agricola, Eustachio / Gaspardone, Achille / Montorfano, Matteo / Mazzone, Patrizio

The Canadian journal of cardiology

2024

Abstract: Introduction: In patients with atrial fibrillation (AF) on vitamin K antagonist (VKA) therapy and therapeutical INR range the incidence of cardiac thromboembolism is not negligible and the subgroup carrying a mechanical prosthetic mitral valve (PMV) has ...

Abstract	Introduction: In patients with atrial fibrillation (AF) on vitamin K antagonist (VKA) therapy and therapeutical INR range the incidence of cardiac thromboembolism is not negligible and the subgroup carrying a mechanical prosthetic mitral valve (PMV) has the highest risk. We aimed to assess the long-term effects of left atrial appendage closure (LAAC) in AF patients carriers of mechanical PMV who experienced a failure of VKA therapy. Methods: In this retrospective, multicenter study, patients underwent LAAC because of thrombotic events including TIA/stroke, systemic embolism and evidence of left atrial appendage thrombosis/sludge despite VKA therapy were enrolled. Patients with mechanical PMV were included and compared with those affected by non valvular AF. The primary endpoint was the composite of all-cause death, major cardiovascular events and major bleedings at follow-up. Feasibility and safety of LAAC was also assessed. Results: 55 patients (42% females; mean age 70 ± 9 years) including 12 carriers of mechanical PMV were enrolled. The most frequent indication to LAAC (71%) was LAA thrombosis or sludge. Procedural success was achieved in 96% of overall cases and in 100% of patients with PMV. In 35 patients a cerebral protection device was used. During a median follow-up of 6.1 ± 4.3 years, 4 patients with PMV and 20 patients without PMV reported adverse events (HR 0.73 [95% CI 0.25 - 2.16, p=0.564]). Conclusion: LAAC seems to be a valuable alternative in AF carriers of mechanical PMV with failure of VKA therapy. This off-label, real-world clinical practice indication deserve validation in further studies.
Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Journal Article
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2024.01.039
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Article ; Online: A new echocardiographic index to select patients for PFO suture-mediated percutaneous closure.

Gaspardone, Achille / Sgueglia, Gregory A / Gaspardone, Carlo / De Santis, Antonella / D'Ascoli, Emanuela / Piccioni, Fabiana / Iamele, Maria / Giannico, Maria Benedetta / Tarsia, Carmela / Versaci, Francesco

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

2023 Volume 101, Issue 5, Page(s) 837–846

Abstract: Objectives: To identify a simple echocardiographic predictor of procedural success to select patient for percutaneous suture-mediated patent fossa ovalis (PFO) closure.: Background: Percutaneous suture-mediated PFO closure has been shown as a safe ... ...

Abstract	Objectives: To identify a simple echocardiographic predictor of procedural success to select patient for percutaneous suture-mediated patent fossa ovalis (PFO) closure. Background: Percutaneous suture-mediated PFO closure has been shown as a safe and advantageous alternative to device-based PFO closure, yet its overall success is slightly lower in unselected patients. Methods: Preprocedural transesophageal echocardiogram (TEE) of 302 patients (113 men, 45 ± 12 years) who underwent percutaneous suture-mediated PFO closure were reviewed. Results: At echocardiographic follow-up (3-6 months), residual right-to-left shunt (RLS) ≥2 was found in 60 (19.9%) patients. At multivariable analysis, only two anatomical variables measured at preprocedural TEE were found as independent predictors of residual RLS ≥ 2 at follow-up: PFO maximum width (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.16-3.40, p = 0.02) and PFO minimal septa overlapping (OR 0.58, 95% CI 0.35-0.88, p = 0.02). An index based on the ratio of PFO maximum width to PFO minimum septal overlapping (W/SO) proved to be the most powerful predictor of RLS ≥ 2 at follow-up (OR 48.1, 95% CI 9.3-352.2, p < 0.01). The ROC curve for the W/SO ratio was found to have an AUC of 0.84 (95% CI 0.75-0.93) and a cut-off value of 0.61 yielding a sensitivity of 80% and specificity of 78% with a negative predictive value of 94%. A decision tree methodology's AUC was 0.75 (95% CI 0.67-0.83). Conclusions: The results of this study indicate that the ratio between the maximum amplitude of the PFO and the minimum overlap of the septa is the best predictive index of a favorable result by using one stitch only.
MeSH term(s)	Male ; Humans ; Foramen Ovale, Patent/diagnostic imaging ; Foramen Ovale, Patent/therapy ; Treatment Outcome ; Echocardiography ; Echocardiography, Transesophageal ; Sutures ; Cardiac Catheterization/adverse effects
Language	English
Publishing date	2023-02-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1459995-8
ISSN	1522-726X ; 1522-1946
ISSN (online)	1522-726X
ISSN	1522-1946
DOI	10.1002/ccd.30604
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Article ; Online: Quantification of Mitral Regurgitation in Mitral Valve Prolapse by Three-Dimensional Vena Contracta Area: Derived Cutoff Values and Comparison With Two-Dimensional Multiparametric Approach.

Fiore, Giorgio / Ingallina, Giacomo / Ancona, Francesco / Gaspardone, Carlo / Biondi, Federico / Margonato, Davide / Morosato, Michele / Belli, Martina / Tavernese, Annamaria / Stella, Stefano / Agricola, Eustachio

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography

2024

Abstract: Background: Echocardiographic grading of mitral regurgitation (MR) in mitral valve prolapse (MVP) is challenging. Three-dimensional (3D) vena contracta area (VCA) has been proposed as a valuable method. However, data defining the cutoff values of ... ...

Abstract	Background: Echocardiographic grading of mitral regurgitation (MR) in mitral valve prolapse (MVP) is challenging. Three-dimensional (3D) vena contracta area (VCA) has been proposed as a valuable method. However, data defining the cutoff values of severity and validation in the subset of patients with MVP are scarce. The aim of this study was to validate the 3D VCA by 3D color-Doppler transesophageal echocardiography (TEE) in patients with MVP and to define the cutoff values of severity grading. The secondary aim was to compare 3D VCA to the effective regurgitant orifice area estimation by proximal isovelocity surface area (EROA-PISA) method. Methods: A total of 1,138 patients with at least moderate MR who underwent TEE were included. Three-dimensional VCA was measured, and the cutoff value and area under the curve (AUC) for the prediction of severe MR were estimated by receiver operating characteristic curve using a guideline-suggested multiparametric approach as the reference standard. In a subgroup of patients, 3D regurgitant volume (RV) and 3D fraction were calculated from mitral and left ventricular outflow tract stroke volumes to further validate 3D VCA against a 3D volumetric reference standard. Results: The optimal 3D VCA cutoff value for predicting severe MR was 0.45 cm Conclusions: The present study suggests 0.45 cm
Language	English
Publishing date	2024-03-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	1035622-8
ISSN	1097-6795 ; 0894-7317
ISSN (online)	1097-6795
ISSN	0894-7317
DOI	10.1016/j.echo.2024.03.009
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Zs.A 2638: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Cardiologist's approach to the diabetic patient: No further delay for a paradigm shift.

Maranta, Francesco / Cianfanelli, Lorenzo / Gaspardone, Carlo / Rizza, Vincenzo / Grippo, Rocco / Ambrosetti, Marco / Cianflone, Domenico

International journal of cardiology

2021 Volume 338, Page(s) 248–257

Abstract: Type 2 diabetes mellitus (DM) is constantly increasing worldwide and its most critical determinant of morbidity and mortality is still represented by cardiovascular (CV) complications. For years, cardiologists' approach to diabetic patients has been ... ...

Abstract	Type 2 diabetes mellitus (DM) is constantly increasing worldwide and its most critical determinant of morbidity and mortality is still represented by cardiovascular (CV) complications. For years, cardiologists' approach to diabetic patients has been focused on risk factors optimization, with positive results. However, the management of DM per se was never truly considered in order to obtain prevention from major CV events, because medications used for glycemic control were not expected to gain CV benefit. Early trials concerning intensive versus conventional glycemia control did not prove useful in reducing the number of CV events. The introduction of new molecules led to a game change in DM treatment, as some new glucose-lowering drugs (GLDs), such as sodium-glucose linked transporter-2 inhibitors (SGLT-2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA), showed not only to be safe but also to ensure CV benefit. A combination of anti-atherogenic effects and hemodynamic improvements are likely explanations of the observed reduction of CV events and mortality. These evidence opened a completely new era in the field of GLDs and of DM treatment. Nonetheless, the presence of residual cardiovascular risk despite optimal medical therapy remains an issue and an aggressive strategy against multiple risk factors is suggested. A paradigm shift toward a new approach to DM management should be made with no further delay with the use of medications that may prevent CV events in an integrated strategy of CV risk reduction.
MeSH term(s)	Cardiologists ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Glucagon-Like Peptide-1 Receptor ; Humans ; Hypoglycemic Agents
Chemical Substances	Glucagon-Like Peptide-1 Receptor ; Hypoglycemic Agents
Language	English
Publishing date	2021-05-29
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2021.05.050
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Zs.A 1673: Show issues

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Article ; Online: A Novel Formula for Estimating Left Ventricular Outflow Tract Diameter.

Gaspardone, Carlo / Morosato, Michele / Morciano, Davide Antonio / Mager, Riccardo / Fasolino, Alessandro / Baldetti, Luca / Romagnolo, Davide / Fiore, Giorgio / Ingallina, Giacomo / Ancona, Francesco / Stella, Stefano / Godino, Cosmo / Agricola, Eustachio

The Canadian journal of cardiology

2023 Volume 39, Issue 12, Page(s) 1986–1988

Language	English
Publishing date	2023-09-20
Publishing country	England
Document type	Letter
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2023.09.018
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Article ; Online: Potential Cardiologic Protective Effects of Acetylcholinesterase Inhibitors in Patients With Mild to Moderate Dementia.

Rampa, Lorenzo / Santangelo, Roberto / Gaspardone, Carlo / Cerutti, Alice / Magnani, Giuseppe / Piscazzi, Francesco / Sgherzi, Giulia / Fiore, Giorgio / Filippi, Massimo / Agosta, Federica / Margonato, Alberto / Fragasso, Gabriele

The American journal of cardiology

2023 Volume 200, Page(s) 162–170

Abstract: In patients with mild to moderate dementia, acetylcholinesterase inhibitors (AChE-I) are used to improve cognitive functions, but bradycardia, conduction abnormalities, and hypotension are possible side effects because of the peripheral muscarinic M2 ... ...

Abstract	In patients with mild to moderate dementia, acetylcholinesterase inhibitors (AChE-I) are used to improve cognitive functions, but bradycardia, conduction abnormalities, and hypotension are possible side effects because of the peripheral muscarinic M2 receptor stimulation. This study aimed to evaluate the main cardiologic clinical outcomes in patients with dementia who are on AChE-I. In this retrospective, monocentric, observational cohort study, 2 groups were considered: (1) patients with dementia because of the typical and atypical forms of Alzheimer disease treated with AChE-I and (2) cognitively unimpaired, matched control group. The primary end point was a composite of cardiovascular death, nonfatal acute myocardial infarction, myocardial revascularization, occurrence of stroke and/or transient ischemic attacks, and hospitalization for heart failure occurring during a mean of 3.1 years of follow-up. The secondary end points were each individual component of the primary end point, total mortality, noncardiovascular death, and incidence of pacemaker implant. Each group included 221 patients who were homogeneous in terms of age, gender, and main cardiovascular risk factors. Major adverse cardiovascular events occurred in 24 patients with dementia (2.1 per 100 patient-years) compared with 56 in control group (5.0 per 100 patient-years), p = 0.036. Even if not significant, the difference was mainly driven by myocardial revascularization (3.2% vs 6.8%) and hospitalization for heart failure (4.5% vs 14.5%). As expected, noncardiovascular mortality was significantly higher in the treatment group (13.6% vs 2.7% p = 0.006). No significant difference between the groups was observed in terms of other secondary outcomes. In conclusion, in patients with dementia, the use of AChE-I may be protective for cardiovascular outcomes, especially in reducing heart failure hospitalization and myocardial revascularization.
MeSH term(s)	Humans ; Cholinesterase Inhibitors/therapeutic use ; Acetylcholinesterase ; Retrospective Studies ; Heart Failure/drug therapy ; Heart Failure/epidemiology ; Dementia/epidemiology
Chemical Substances	Cholinesterase Inhibitors ; Acetylcholinesterase (EC 3.1.1.7)
Language	English
Publishing date	2023-06-14
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2023.05.041
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Article ; Online: Accuracy and Reliability of Left Atrial Appendage Morphology Assessment by Three-Dimensional Transesophageal Echocardiographic Glass Rendering Modality: A Comparative Study With Computed Tomography.

Fiore, Giorgio / Gaspardone, Carlo / Ingallina, Giacomo / Rizza, Vincenzo / Melillo, Francesco / Stella, Stefano / Ancona, Francesco / Biondi, Federico / Margonato, Davide / Palmisano, Anna / Esposito, Antonio / Agricola, Eustachio

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography

2023 Volume 36, Issue 10, Page(s) 1083–1091

Abstract: Background: Contrast-enhanced computed tomography is the reference-standard imaging technique to assess left atrial appendage (LAA) morphology. The aim of this study was to evaluate the accuracy and reliability of two-dimensional and new three- ... ...

Abstract	Background: Contrast-enhanced computed tomography is the reference-standard imaging technique to assess left atrial appendage (LAA) morphology. The aim of this study was to evaluate the accuracy and reliability of two-dimensional and new three-dimensional (3D) transesophageal echocardiographic rendering modalities in assessing LAA morphology. Methods: Seventy consecutive patients who underwent both computed tomography and transesophageal echocardiography (TEE) were retrospectively enrolled. The traditional LAA morphology classification system (LAAcs; chicken wing, cauliflower, cactus, and windsock) and a new simplified LAAcs based on the LAA bend angle were used for the analysis. LAA morphology was independently assessed by two trained readers using three different modalities: two-dimensional TEE, 3D TEE with multiplanar reconstruction, and a new 3D transesophageal echocardiographic rendering modality with improved transparency (Glass). The new LAAcs and traditional LAAcs were compared in terms of intra- and interrater reliability. Results: With the new LAAcs, two-dimensional TEE was fairly accurate in identifying LAA morphology (κ = 0.43, P < .05), with moderate interrater (κ = 0.50, P < .05) and substantial intrarater (κ = 0.65, P < .005) agreement. Three-dimensional TEE showed higher accuracy and reliability: 3D TEE with multiplanar reconstruction had almost perfect accuracy (κ = 0.85, P < .001) and substantial (κ = 0.79, P < .001) interrater reliability, while 3D TEE with Glass had substantial accuracy (κ = 0.70, P < .001) and almost perfect (κ = 0.84, P < .001) interrater reliability. Intrarater agreement was almost perfect for both 3D transesophageal echocardiographic modalities (κ = 0.85, P < .001). Accuracy was considerably lower when the traditional LAAcs was used, with 3D TEE with Glass being the most reliable technique (κ = 0.75, P < .05). The new LAAcs showed higher inter- and intrarater reliability compared with the traditional LAAcs (interrater, κ = 0.85 vs κ = 0.49; intrarater, κ = 0.94 vs κ = 0.68; P < .05). Conclusions: Three-dimensional TEE is an accurate, reliable, and feasible alternative to computed tomography in assessing LAA morphology with the new LAAcs. The new LAAcs shows higher reliability rates than the traditional one.
MeSH term(s)	Humans ; Echocardiography, Transesophageal/methods ; Atrial Appendage ; Atrial Fibrillation ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed
Language	English
Publishing date	2023-06-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	1035622-8
ISSN	1097-6795 ; 0894-7317
ISSN (online)	1097-6795
ISSN	0894-7317
DOI	10.1016/j.echo.2023.05.013
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Zs.A 2638: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Performances of HEART score to predict 6-month prognostic of emergency department patients with chest pain: a retrospective cohort analysis.

Fiore, Giorgio / Pinto, Giuseppe / Preda, Alberto / Rampa, Lorenzo / Gaspardone, Carlo / Oppizzi, Michele / Slavich, Massimo / Di Napoli, Davide / Bianchi, Gianluca / Etteri, Massimiliano / Margonato, Alberto / Fragasso, Gabriele

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

2023 Volume 30, Issue 3, Page(s) 179–185

Abstract: Background and importance: Chest pain is a frequent cause of patient admissions in emergency departments (EDs). Clinical scores can help in the management of chest pain patients with an undefined impact on the appropriateness of hospitalization or ... ...

Abstract	Background and importance: Chest pain is a frequent cause of patient admissions in emergency departments (EDs). Clinical scores can help in the management of chest pain patients with an undefined impact on the appropriateness of hospitalization or discharge when compared to usual care. Objectives: The aim of this study was to assess the performances of the HEART score to predict the 6-month prognostic of patients presenting to the ED of a tertiary referral university hospital with non-traumatic chest pain. Design, settings, and participants: From 7040 patients presenting with chest pain from 1 January 2015 to 31 December 2017, after applying exclusion criteria (ST-segment elevation >1 mm, shock, absence of telephone number) we selected a sample of 20% chosen randomly. We retrospectively assessed the clinical course, definitive diagnosis, and HEART score according to ED final report. Follow-up was made by telephone interview with discharged patients. In hospitalized patients, clinical records were analyzed to evaluate major adverse cardiac events (MACE) incidence. Outcome measure and analysis: The primary endpoint was MACE, comprising cardiovascular death, myocardial infarction, or unscheduled revascularization at 6 months. We assessed the diagnostic performance of the HEART score in ruling out MACE at 6 months. We also assessed the performance of ED usual care in the management of chest pain patients. Results: Of 1119 screened, 1099 were included for analysis after excluding patients lost to follow-up; 788 patients (71.70%) had been discharged and 311 (28.30%) were hospitalized. Incident MACE was 18.3% ( n = 205). The HEART score was retrospectively calculated in 1047 patients showing increasing MACE incidence according to risk category (0.98% for low risk, 38.02% for intermediate risk, and 62.21% for high risk). Low-risk category allowed to safely exclude MACE at 6 months with a negative predictive value (NPV) of 99%. Usual care diagnostic performance showed 97.38% sensitivity, 98.24% specificity, 95.5% positive predictive value, and 99% NPV, with an overall accuracy of 98.00%. Conclusions: In ED patients with chest pain, a low HEART score is associated with a very low risk of MACE at 6 months.
MeSH term(s)	Humans ; Retrospective Studies ; Prognosis ; Risk Assessment ; Chest Pain/diagnosis ; Chest Pain/etiology ; Cohort Studies ; Emergency Service, Hospital ; Electrocardiography
Language	English
Publishing date	2023-04-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1233544-7
ISSN	1473-5695 ; 0969-9546
ISSN (online)	1473-5695
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000001022
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Article ; Online: Kounis syndrome after almonds ingestion

Giorgio Fiore / Carlo Gaspardone / Silvana Di Maio / Michele Oppizzi / Alberto Margonato

Emergency Care Journal, Vol 17, Iss

From the diagnostic approach to new therapeutic options

2021 Volume 3

Abstract: Acute coronary syndromes can develop with an unusual and challenging presentation. Kounis syndrome is a mostly overlooked Acute Coronary Syndrome (ACS) in the setting of anaphylactic or anaphylactoid reactions in response to an allergic insult that can ... ...

Abstract	Acute coronary syndromes can develop with an unusual and challenging presentation. Kounis syndrome is a mostly overlooked Acute Coronary Syndrome (ACS) in the setting of anaphylactic or anaphylactoid reactions in response to an allergic insult that can lead to severe complications including cardiac arrest. A 52-yearold- man presented to the emergency department of our hospital because of acute transient loss of consciousness that developed some minutes after almonds ingestion. The complex diagnostic workup led to the diagnosis of vasospastic Kounis syndrome, an infrequent type of acute coronary syndrome, mostly overlooked, with challenging diagnostic and therapeutic features. Peculiarities on clinical presentation, the approach adopted by the emergency physician and the consultant cardiologist to achieve the correct diagnosis and our proposed management with a brief revision of the literature will be reported. Unusual clinical presentations of acute coronary syndromes represent part of the pitfalls that an emergency physician can face during the everyday practice. Prompt identification of these conditions is always struggling but of crucial importance to improve patient prognosis with a correct diagnostic work-up and therapeutic management.
Keywords	Kounis syndrome ; allergic angina ; vasospastic angina ; acute chest pain ; acute coronary syndrome ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	PAGEPress Publications
Document type	Article ; Online
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Article ; Online: Percutaneous suture-mediated patent foramen ovale closure: two-year clinical follow-up.

Gaspardone, Achille / Cinque, Alessandra / Beggio, Elisa / DE Santis, Antonella / D'Ascoli, Emanuela / Piccioni, Fabiana / Iamele, Maria / Sgueglia, Gregory A / Gaspardone, Carlo / DI Matteo, Antonio / Versaci, Francesco

Minerva cardiology and angiology

2021 Volume 71, Issue 2, Page(s) 169–174

Abstract: Background: Percutaneous suture-mediated patent foramen ovale (PFO) closure has been recently introduced in clinical practice showing a favorable efficacy and safety profile in most PFO cases. The aim of this study was to assess the long-term outcomes ... ...

Abstract	Background: Percutaneous suture-mediated patent foramen ovale (PFO) closure has been recently introduced in clinical practice showing a favorable efficacy and safety profile in most PFO cases. The aim of this study was to assess the long-term outcomes of PFO closure by direct suture in a large consecutive series of patients. Methods: We extracted all consecutive patients who underwent percutaneous closure of the PFO by suture technique (HeartStitch, Fountain Valley, CA, USA) from June 2016 with a follow-up of at least 2 years. After PFO closure, patients were followed-up clinically at 1, 6 and up to 12 months and microbubble transthoracic echocardiography (TTE) scheduled between 3 and 6 months, and at 12-month follow-up. After 12 months, patients were clinically checked every 6 months. Results: As of September 1, 2020, 187 patients had undergone PFO closure with suture for at least two years and, of these, 181 (121 women and 60 men, mean age 45±13 years, range 15-75 years) had complete clinical and instrumental follow-up (97%). There were no peri-procedural complications. Mean follow-up was 1076±251 days (range 727-1574). At 12-month TTE, a significant residual atrial shunt was found in 39 patients (21%). At follow-up no recurrent thromboembolic or cerebral event occurred, no instrumental evidence of suture dehiscence detected and, 18 months after the procedure, one patient had an episode of transient atrial fibrillation lasting less than 24 hours and resolved spontaneously. Conclusions: Long-term follow-up data indicate that PFO closure by direct suturing is safe and effective. Two years after the procedure, there were no significant complications, no permanent arrhythmic complications and evidence of suture dehiscence.
MeSH term(s)	Male ; Humans ; Female ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Foramen Ovale, Patent/diagnostic imaging ; Foramen Ovale, Patent/surgery ; Foramen Ovale, Patent/complications ; Follow-Up Studies ; Treatment Outcome ; Echocardiography ; Sutures
Language	English
Publishing date	2021-06-17
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3059238-0
ISSN	2724-5772
ISSN (online)	2724-5772
DOI	10.23736/S2724-5683.21.05718-5
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Inter-library loan at ZB MED

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