Left Atrial Dysfunction in Patients With Patent Foramen Ovale and Atrial Septal AneurysmAn Alternative Concurrent Mechanism for Arterial Embolism?
Gianluca Rigatelli, MD*,*,
Silvio Aggio, MD ,
Paolo Cardaioli, MD*,
Gabriele Braggion, MD,
Massimo Giordan, MD*,
Fabio Dell'avvocata, MD*,
Mauro Chinaglia, MD ,
Giorgio Rigatelli, MD ,
Loris Roncon, MD,
Jack P. Chen, MD||
* Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
Division of Cardiology, Echocardiography Lab, Rovigo General Hospital, Rovigo, Italy
Department of Neuroscience, Rovigo General Hospital, Rovigo, Italy
Department of Specialistic Medicine, Divisione of Cardiology, Legnago General Hospital, Verona, Italy
|| Saint Joseph's Translational Research Institute, Atlanta, Georgia
View larger version (15K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 1 PFO Versus PFO and ASA
Comparison of left atrial (LA) functional parameters and anatomical characteristics between patients with patent foramen ovale (PFO) and moderate to severe atrial septal aneurysms (ASA) versus those with isolated PFO, suggesting a higher risk profile in patients with PFO and ASA.
|
|
View larger version (32K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 2 ICE Study
(A) Intracardiac echocardiography (ICE) before closure in a 49-year-old man with a huge atrial septal aneurysms (ASA): note the smoke-like spontaneous echo-contrast with the typical swirling inside the ASA on its left side. (B) Stabilization of the ASA with an Amplatzer ASD Cribriform Occluder 25/25 mm (AGA Medical Corporation, Golden Valley, Minnesota) in the same patient: an electrophysiological procedure performed 3 months later gave the occasion for an ICE control that demonstrated complete ASA stabilization with no demonstrable spontaneous echocontrast (SEC). gw = guidewire across the PFO; MV = mitral valve; rim = septum secundum rim; TV = tricuspid valve.
|
|
View larger version (27K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 3 LA Function Before and After Closure
Comparison of left atrial (LA) passive emptying fraction and LA volume max between healthy subjects and patent foramen ovale (PFO) patients before and after closure with various occlusion devices: the LA compliance and global function is remarkably abnormal in PFO patients before closure and tends to normalize after closure. Max ind. s.c. and RR = indexed for body surface and RR interval.
|
|
|
