Impact of Patent Foramen Ovale Anatomical Complexity on Fluoroscopy Time During Transcatheter Closure
Acta Cardiologica Sinica, cilt.42, sa.3, ss.360-370, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 42 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.6515/acs.202605_42(3).20250904a
- Dergi Adı: Acta Cardiologica Sinica
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Sayfa Sayıları: ss.360-370
- Anahtar Kelimeler: Anatomical complexity, Cryptogenic stroke, Fluoroscopy time, Patent foramen ovale closure, Transesophageal echocardiography
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Complex patent foramen ovale (PFO) anatomical features can increase procedural difficulty during closure, often leading to prolonged fluoroscopy time. Aim: This study aimed to evaluate the relationship between PFO anatomy, assessed via transesophageal echocardiography (TEE), and prolonged fluoroscopy time during transcatheter closure. Methods: This retrospective study analyzed 83 patients (median age: 45 years, 58% male) undergoing PFO closure for cryptogenic stroke. TEE measurements included key anatomical parameters related to PFO morphology and shunting dynamics. Patients were categorized into prolonged (≥ 80th percentile) and standard (< 80th percentile) fluoroscopy-time groups. Logistic regression, Pearson correlation analysis, and receiver operating characteristic (ROC) curve analyses were used to identify predictors of prolonged fluoroscopy time. Results: The prolonged fluoroscopy-time group had a significantly longer tunnel length (17.5 mm [interquartile range (IQR): 14.25-20.75] vs. 12.0mm[IQR: 8.00-14.00], p < 0.01) and smaller aortic rim (3.0mm[IQR: 2.0-3.75] vs. 6.0mm[IQR: 5.0-8.0], p < 0.01). Fluoroscopy time correlated positively with tunnel length (r = 0.72, p < 0.001) and negatively with aortic rim length (r =-0.65, p < 0.001). Logistic regression identified tunnel length (odds ratio [OR] = 1.459; 95% confidence interval [CI]: 1.190-1.789) and aortic rim length (OR = 0.537; 95% CI: 0.378-0.764) as independent predictors. ROC curve analysis revealed a cut-off of 12.5mm(area under the curve [AUC] = 0.770) for tunnel length and 5.5 mm (AUC = 0.798) for aortic rim in predicting prolonged fluoroscopy time. Conclusion: The findings of this study suggest that complex PFO anatomical features significantly impact fluoroscopy time, underscoring the need for detailed pre-procedural TEE assessments to optimize procedural planning and outcomes.