Case ReportNobleStitch EL PFO Closure Guided by Transesophageal Echocardiography
Section snippets
Case
A 70-year-old man, with a history of cryptogenic stroke, was scheduled for a PFO closure using the NobleStitch EL PFO closure technique.6 Recently, the patient had experienced a stroke, with a left cerebellar infarct detected by computed tomography. At that time, the patient was treated with thrombolytic therapy, and subsequently had no residual neurologic deficits. The patient's medical history was otherwise only significant for a remote history of smoking. He was an avid runner whose only
Discussion
Paradoxical embolism via a residual or persistent PFO is a recognized cause of cryptogenic stroke, arterial embolism, migraine, decompression sickness, and platy-orthodeoxia syndrome.6,8 Endovascular closure of PFOs has gained popularity in recent years,8,9 with many novel percutaneous techniques being introduced. NobleStitch is one such technique that applies a suture through the septum primum, as well as a suture through the septum secundum, and then applies a knot to the two sutures, thereby
Conflict of Interest
None.
References (16)
- et al.
Early and late complications associated with transcatheter occlusion of secundum atrial septal defect
J Am Coll Cardiol
(2002) - et al.
Incidence of thrombus formation on the CardioSEAL and the Amplatzer interatrial closure devices
Am J Cardiol
(2004) - et al.
Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions
J Am Soc Echocardiogr
(2015) - et al.
Interatrial septal tear after patent foramen ovale closure with the NobleStitch device
JACC Cardiovasc Interv
(2019) - et al.
Brachial plexus injury related to patient positioning
J Vasc Interv Radiol
(2007) - et al.
Thrombus formation on amplatzer septal occluder device: Pinning down the cause
Case Rep Cardiol
(2014) - et al.
Percutaneous devices for left atrial appendage occlusion: A contemporary review
World J Cardiol
(2019) - et al.
Endocarditis and incomplete endothelialization 12 years after Amplatzer septal occluder deployment
Tex Heart Inst J
(2016)
Cited by (2)
NobleStitch Patent Foramen Ovales Closure for Recurrent Strokes in a Patient with COVID-19 on Extracorporeal Membrane Oxygenation
2023, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Another prospective single-center study with a 6-month follow-up period (n = 116) investigated factors that may have contributed to a residual intracardiac shunting grade ≥2 (20%, n = 23), and revealed partial stitch detachment (n = 12), atrial septal tear (n = 3), and KwiKnot embolization (n = 2) as the main causes of right-to-left shunting at follow-up.17 Although the NobleStitch is not without complications, it has clear advantages over commonly used device PFO closures.5,6,17 This case highlighted how the NobleStitch procedure may be used to close a PFO in a COVID-19 patient with refractory hypoxemia and cryptogenic stroke on VV_ECMO.
Intracardiac Echocardiography and Our Evolving Role
2021, Journal of Cardiothoracic and Vascular Anesthesia