Practical Aspects of Patent Foramen Ovale Closure: Ultrasound and Fluoroscopic Guidance

Cardiol Clin. 2024 Nov;42(4):537-545. doi: 10.1016/j.ccl.2024.02.001. Epub 2024 Mar 13.

Abstract

Percutaneous PFO closure is a well-established medical procedure to mitigate paradoxic embolism and the future risk of stroke in a well-selected patient clientele. When it comes to procedural guidance during PFO closure, various modalities exist, each with its own advantages and disadvantages. Guidance by transesophageal echocardiography (in combination with fluoroscopy) offers high-resolution 2D/3D imaging, however, it requires the presence of a peri-interventional imager and conscious sedation (or endotracheal intubation). Intracardiac echocardiography and fluoroscopy guidance can be performed by a single operator and omits the need for conscious sedation (or endotracheal intubation).

Keywords: Angiographic guidance; Fluoroscopic guidance; ICE; PFO closure; Periprocedural management; TEE.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization* / methods
  • Echocardiography, Transesophageal* / methods
  • Fluoroscopy / methods
  • Foramen Ovale, Patent* / complications
  • Foramen Ovale, Patent* / diagnostic imaging
  • Foramen Ovale, Patent* / surgery
  • Humans
  • Septal Occluder Device
  • Stroke / etiology
  • Stroke / prevention & control
  • Ultrasonography, Interventional* / methods