Advances in Interventional Cardiology (Sep 2021)

Very long-term follow-up after in-tunnel patent foramen ovale closure with FlatStent EF: still an attractive option?

  • Eustaquio M. Onorato,
  • Vittorio Ambrosini,
  • Francesco Casilli,
  • Antonio L. Bartorelli

DOI
https://doi.org/10.5114/aic.2021.109155
Journal volume & issue
Vol. 17, no. 3
pp. 319 – 321

Abstract

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We present a case of a 38-year-old woman, aura migraineur, with a past medical history of Hashimoto’s thyroiditis and elevated homocysteine level of 75 µmol/l due to homozygous C677T MTHFR gene mutation on folic acid supplementation. In December 2009 a right-sided hemiparesis on awakening occurred and brain magnetic resonance imaging confirmed left thalamic infarct. Continuous ECG monitoring ruled out atrial fibrillation. A Doppler study of lower limbs revealed no overt thrombosis. Extracranial duplex ultrasound examination was normal and carotid dissection was excluded. Two-dimensional (2D) transthoracic/transesophageal echocardiography (TTE/TEE) color Doppler showed a right-to-left shunt (RLS) via a long tunnel-type patent foramen ovale (PFO), with an overlap between the primum and secundum septum of 13 mm along with a prominent Eustachian valve.