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- W4387270316 abstract "Percutaneous closure of Patent foramen ovale (PFO) is indicated in patients with cryptogenic stroke to reduce the risk of recurrent embolic events. Transfemoral access has been the mainstay approach to PFO closure, but in patients with congenital IVC interruption, trans-hepatic approach can be successfully performed. A 59 year old man with medical history of Type II DM presented with sudden left sided weakness of seven hours duration. On brain imaging he was found to have right hemispheric cortical infarcts without significant cerebrovascular stenosis. Hypercoagulable work up was unremarkable and underlying Atrial fibrillation was ruled out by continuous cardiac telemetry. Transthoracic echocardiography with bubble study demonstrated a PFO with interatrial shunt. As a result, the etiology of his stroke was attributed to paradoxical embolism and he was referred for a PFO closure. Intra-procedure, IVC angiogram demonstrated an interrupted IVC at the intrahepatic segment with continuation of the IVC by prominent hemiazygos and azygos veins which re-directed the IVC catheter into the thorco-abdominal hemi-azygos system (Fig 1A). An MRI done demonstrated similar findings and a supra-hepatic continuation of the IVC into the right atrium (Fig 1B). His Internal-jugular veins were also considered unsuitable access, as a result an alternative trans-hepatic venous approach was adopted in collaboration with interventional radiology which resulted in successful closure without any complications. Congenital anomalies of the IVC are uncommon but can preclude conventional trans-femoral venous interventions. Recognition of these anomalies can aid pre-procedural planning and multidisciplinary collaboration essential for optimal outcome. Percutaneous PFO closure in patients with interrupted IVC anomalies can be successfully performed through a trans-hepatic approach in collaboration with interventional radiologists." @default.
- W4387270316 created "2023-10-03" @default.
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- W4387270316 date "2023-05-01" @default.
- W4387270316 modified "2023-10-03" @default.
- W4387270316 title "Abstract 600: Percutaneous Transhepatic Approach To Patent Foramen Ovale Closure In A Patient With Congenital Inferior Vena Cava Interruption" @default.
- W4387270316 doi "https://doi.org/10.1161/atvb.43.suppl_1.600" @default.
- W4387270316 hasPublicationYear "2023" @default.
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