1. Should we close hypoxaemic patent foramen ovale and interatrial shunts on a systematic basis?
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Béatrice Bonello, Gilbert Habib, Alain Fraisse, Andreea Dragulescu, Bertrand Jop, Mohammad El Tahlawi, and Francis Rouault
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Male ,Cardiac Catheterization ,Time Factors ,Heart disease ,Septal Occluder Device ,Heart Septal Defects, Atrial ,Hypoxemia ,Medicine ,Respiratory system ,Interventional closure ,Foramen ovale perméable ,Hypoxia ,Chronic respiratory insufficiency ,General Medicine ,Middle Aged ,Treatment Outcome ,Cardiology ,Female ,France ,Fermeture percutanée ,medicine.symptom ,Respiratory Insufficiency ,Cardiology and Cardiovascular Medicine ,Shunt (electrical) ,medicine.medical_specialty ,Partial Pressure ,Foramen secundum ,Foramen Ovale, Patent ,Persistent fetal circulation ,Hypoxémie ,Internal medicine ,Humans ,In patient ,Adverse effect ,Aged ,Retrospective Studies ,business.industry ,Patient Selection ,Hemodynamics ,Retrospective cohort study ,Recovery of Function ,Oxygenation ,medicine.disease ,Pulmonary hypertension ,Patent foramen ovale ,Surgery ,Oxygen ,Respiratory failure ,Chronic Disease ,business ,Hypoxaemia - Abstract
SummaryBackgroundRarely, hypoxaemia is associated with shunt reversal at the atrial level. Closure by interventional catheterization is the treatment of choice but indications and results have been studied insufficiently.PurposeTo describe our experience with interventional closure of atrial right-to-left shunts described as hypoxaemic and the impact on patient oxygenation and clinical status.MethodRetrospective study in two referral centres, including all patients undergoing closure of interatrial right-to-left shunt associated with hypoxaemia.ResultsSince 2001, 21 consecutive patients underwent interventional shunt closure using the “Amplatzer® device”; two patients had atrial septal defect and 19 had patent foramen ovale. Three patients had minor adverse events; two patients have a tiny residual shunt. Transcutaneous oxygen saturation and partial oxygen pressure increased significantly from 86±5 to 95±3% (p
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