Author + information
- Received May 15, 2013
- Revision received July 2, 2013
- Accepted July 30, 2013
- Published online February 11, 2014.
- Smita R. Jategaonkar, MD,
- Nikola Bogunovic, MSc,
- Dieter Horstkotte, MD, PhD and
- Werner Scholtz, MD
In a 22-year-old woman suffering from ischemic stroke affecting the posterior cerebral artery, clinical work-up ruled out cardiovascular and neurological pathologies except patent foramen ovale (PFO) with septal aneurysm and complete bubble filling of the left atrium as demonstrated by echocardiography. The patient was scheduled for transcatheter PFO closure. Peri-interventional 3-dimensional transesophageal echocardiography revealed a PFO tunnel and a left atrial chord keeping the PFO open, with consequent continuous left to right shunting (A to C; Online Video 1). Balloon sizing demonstrated a tunnel diameter of 16 mm (D). A 16-mm Amplatzer ASD occluder (St. Jude Medical, St. Paul, Minnesota) was implanted (E and F, Online Video 2) adhering to the atrial chord. Intraprocedural imaging was extremely helpful for device selection and positioning of the left atrial occluder disk to facilitate partial coverage and slightly lifting of the chord, yet no longer directly adjacent to the interatrial septum (E and F). No residual shunt was detected by final contrast angiogram.
- Received May 15, 2013.
- Revision received July 2, 2013.
- Accepted July 30, 2013.
- American College of Cardiology Foundation