Prevention of recurrent cryptogenic stroke with percutaneous closure of patent foramen ovale; one year follow-up study with magnetic resonance imaging and Holter monitoring [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2015; 43(1): 38-46 | DOI: 10.5543/tkda.2015.68148

Prevention of recurrent cryptogenic stroke with percutaneous closure of patent foramen ovale; one year follow-up study with magnetic resonance imaging and Holter monitoring

Ahmet Hakan Ateş1, Hamza Sunman2, Kudret Aytemir3, Hikmet Yorgun3, Uğur Canpolat4, Mehmet Akif Topcuoğlu5, Kader Karlı Oğuz6, Levent Şahiner3, Ergün Barış Kaya3, Lale Tokgözoğlu3, Giray Kabakçı3, Ali Oto3
1Department of Cardiology, Samsun Education And Research Hospital, Samsun, Turkey
2Department of Cardiology, Dıskapı Yıldırım Beyazıt Research And Educational Hospital, Ankara, Turkey
3Department of Cardiology, Hacettepe University, Ankara, Turkey
4Department of Cardiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
5Department of Neurology, Hacettepe University, Ankara, Turkey
6Department of Radiology, Hacettepe University, Ankara, Turkey


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.

Keywords: Electrocardiography, ambulatory, foramen ovale, patent/ therapy; heart catheterization; stroke; magnetic resonance imaging.

How to cite this article
Ahmet Hakan Ateş, Hamza Sunman, Kudret Aytemir, Hikmet Yorgun, Uğur Canpolat, Mehmet Akif Topcuoğlu, Kader Karlı Oğuz, Levent Şahiner, Ergün Barış Kaya, Lale Tokgözoğlu, Giray Kabakçı, Ali Oto. Prevention of recurrent cryptogenic stroke with percutaneous closure of patent foramen ovale; one year follow-up study with magnetic resonance imaging and Holter monitoring. Turk Kardiyol Dern Ars. 2015; 43(1): 38-46

Corresponding Author: Hamza Sunman, Türkiye
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