{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T02:47:02Z","timestamp":1783392422730,"version":"3.54.6"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,11,21]],"date-time":"2014-11-21T00:00:00Z","timestamp":1416528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patent foramen ovale (PFO) is common and may predispose to paradoxical embolism. Transcatheter device closure of PFO can be challenging in certain cases of \u201clong\u2010tunnel\u201d PFO morphology. We report our experience with device closure of long\u2010tunnel PFO using transseptal puncture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed all cases of PFO device closure using transseptal puncture at the Mayo Clinic from January 1, 2010 to September 30, 2013. We arbitrarily defined a PFO tunnel configuration as a tunnel length\u2009\u2265\u200912 mm as observed in intracardiac echocardiography (ICE) at the time of device closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve patients (mean age 40.8 [range 15\u201367] years; 7 males [58%]) underwent PFO device closure with transseptal puncture. The most common indication for PFO closure was previous stroke (<jats:italic>n<\/jats:italic>\u2009=\u20097, 58%). Median tunnel length measured by ICE was 15 mm (12\u201320 mm). GORE\u00ae HELEX\u00ae Septal Occluder was used for closure in all but one patient. The only significant procedural complication was a minor perforation of the left atrial wall during attempted septal puncture, which resulted in a trivial pericardial effusion that resolved without intervention. At latest follow\u2010up (mean 543 days, [range 170\u20131162]) one patient had a residual shunt and subsequently died due to complications during surgical PFO closure. No recurrent strokes or TIAs were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Though not without risk, transseptal puncture can be a valuable tool for facilitating device closure of long\u2010tunnel type PFOs. GORE\u00ae HELEX\u00ae Septal Occluder may be an effective option for facilitating device closure for patients with long\u2010tunnel type PFO. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.25723","type":"journal-article","created":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T07:30:23Z","timestamp":1415345423000},"page":"1053-1057","source":"Crossref","is-referenced-by-count":18,"title":["Transseptal puncture to facilitate device closure of \u201clong\u2010tunnel\u201d patent foramen ovale"],"prefix":"10.1002","volume":"85","author":[{"given":"Alex J.","family":"Thompson","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics Mayo Clinic College of Medicine Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald J.","family":"Hagler","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics Mayo Clinic College of Medicine Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel W.","family":"Taggart","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics Mayo Clinic College of Medicine Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60336-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.8.1172"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198805053181802"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(95)90212-0"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.5.1301"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.02.021"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2013.08.010"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100005825"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000027819.19722.EE"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-300436"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2013.08.698"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1183"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.88.2.e3"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20377"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25106"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-13-0565"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2007.00958.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1810320409"},{"key":"e_1_2_6_20_1","first-page":"665","article-title":"Cardiac perforation during patent foramen ovale closure sealed with an amplatzer PFO occluder","volume":"20","author":"Chiam PT","year":"2008","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2004.047746"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)03160-3"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.25723","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.25723","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T16:13:58Z","timestamp":1696608838000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.25723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,21]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.1002\/ccd.25723"],"URL":"https:\/\/doi.org\/10.1002\/ccd.25723","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11,21]]}}}