Percutaneous closure of the patent foramen ovale using the HELEX® Septal Occluder: acute and long-term results in 405 patients

EuroIntervention. 2012 Oct;8(6):717-23. doi: 10.4244/EIJV8I6A111.

Abstract

Aims: Although routinely used, limited data are available regarding the long-term outcome after patent foramen ovale (PFO) closure using the HELEX® Occluder system. The aim of this study was therefore the examination of the acute and long-term outcome after transcatheter PFO closure using this system.

Methods and results: All (n=407) patients included had undergone PFO closure with the HELEX® Occluder system for secondary prevention of stroke, transient ischaemic attack (TIA) or peripheral embolism at a single centre. Primary endpoints were residual shunts at six or 12 months (assessed by transoesophageal echocardiography) and the number of neurological and other adverse events during follow-up. Device implantation was successful in 99% of patients. Complete closure at six months was achieved in 81%. During follow-up of 1,695 patient-years, 10 neurologic events occurred (four TIA, six strokes). The annual incidence of stroke was 1.2%. Other adverse events were wire frame fractures requiring no further intervention in five (1%), device-associated thrombus formation in one (0.25%), and paroxysmal atrial fibrillation in nine patients (2%).

Conclusions: PFO closure using the HELEX® Occluder system is feasible and safe. Complications and adverse events during long-term follow-up are rare. The safety profile and efficacy in prevention of recurrent events compare well to that reported with other closure devices.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation*
  • Chi-Square Distribution
  • Disease-Free Survival
  • Echocardiography, Transesophageal
  • Embolism / mortality
  • Embolism / prevention & control
  • Female
  • Foramen Ovale, Patent / diagnostic imaging
  • Foramen Ovale, Patent / mortality
  • Foramen Ovale, Patent / therapy*
  • Germany / epidemiology
  • Humans
  • Incidence
  • Ischemic Attack, Transient / mortality
  • Ischemic Attack, Transient / prevention & control
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prospective Studies
  • Prosthesis Design
  • Secondary Prevention / instrumentation*
  • Septal Occluder Device*
  • Stroke / mortality
  • Stroke / prevention & control
  • Time Factors
  • Treatment Outcome
  • Young Adult