Amar Krishnaswamy, MD, FACC

What is a closure device?

Closure devices are used to close a defect or an opening between the right and left sides of the heart. Some of these birth defects are located in the wall (septum) between the upper chambers (atria) of the heart:

The percutaneous closure of PFO and ASD is performed using a special closure device. The device is folded or attached on to a special catheter, similar to the catheter used during your catheterization. The catheter is inserted into a vein in the leg and advanced into the heart and through the defect. The device is slowly pushed out of the catheter allowing each side of the device to open up and cover each side of the hole (like a sandwich), closing the hole or defect. When the device is in proper position, it is released from the special catheter. Over time, heart tissue grows over the implant, becoming part of the heart. The PFO and ASD closure procedures are monitored by X-ray and an ultrasound camera inserted in the heart from a vein in the top of the leg.

AMPLATZERâ„¢ PFO Occluder

AMPLATZERâ„¢ PFO Occluder
AMPLATZER and St. Jude Medical are trademarks of St. Jude Medical, LLC or its related companies. Reproduced with permission of St. Jude Medical, ©2017. All rights reserved.*

Gore Cardioform Device for septal closure

Gore Cardioform Device for septal closure
Photo used with permission from of W. L. Gore & Associates*

What if a closure device is not an option?

Patients who are not candidates for catheter based closure devices, may require surgery to close their septal defect. Minimally invasive and robotically assisted approaches are available. Congenital heart cardiologists, interventionalists and surgeons work together to make sure each patient gets the right procedure to treat their congenital heart condition.

Last reviewed by a Cleveland Clinic medical professional on 04/29/2019.

References

  • Agarwal S, Bajaj NS, Kumbhani DJ, Tuzcu EM, Kapadia SR. Meta-analysis of transcatheter closure versus medical therapy for patent foramen ovale in prevention of recurrent neurological events after presumed paradoxical embolism. JACC Cardiovasc Interv. 2012 Jul;5(7):777-89. doi: 10.1016/j.jcin.2012.02.021.
  • Khan AR, Bin Abdulhak AA, Sheikh MA, Khan S1, Erwin PJ, Tleyjeh I, Khuder S, Eltahawy EA. Device closure of patent foramen ovale versus medical therapy in cryptogenic stroke: a systematic review and meta-analysis.JACC Cardiovasc Interv. 2013 Dec;6(12):1316-23. doi: 10.1016/j.jcin.2013.08.001. Epub 2013 Oct 16.
  • Poddar KL, Nagarajan V, Krishnaswamy A, Bajaj NS, Kumari M, Bdair H, Modi D, Agarwal S, Goel SS, Parashar A, Tuzcu EM, Kapadia SR. Risk of cerebrovascular events in patients with patent foramen ovale and intracardiac devices. JACC Cardiovasc Interv. 2014 Nov;7(11):1221-6. doi: 10.1016/j.jcin.2014.04.025. Epub 2014 Oct 15.

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