{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T06:55:46Z","timestamp":1793170546358,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>NobleStitch EL is a novel suture\u2010based technique used for patent foramen ovale\u00a0(PFO) closure and an alternative to traditional double\u2010disc devices without the need for antithrombotic therapy. However, successful closure rates are still unknown, and certain anatomies may be unfavorable for successful closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We assessed the efficacy of the NobleStitch EL and sought to identify patient\u2010related anatomical features associated with successful suture\u2010based closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 55 patients who underwent PFO closure with the NobleStitch EL in The Netherlands and Switzerland. Successful closure was defined as residual right\u2010to\u2010left shunt grade \u22641 with Valsalva maneuver at a cardiac ultrasound. Predefined possible anatomical determinants for effective closure included PFO length, atrial septal aneurysm, PFO entry\u2010 and exit diameter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Successful closure was achieved in 33 patients (60%). The PFO length was shorter in patients with successful closure compared to unsuccessful closure with a median length of 9.6\u2009mm (IQR 8.0\u201315.0) versus 13.3\u2009mm (IQR 11.4\u201318.6) on preprocedural ultrasound (<jats:italic>p<\/jats:italic>\u2009=\u20090.041) and 9.9\u2009mm (IQR 8.0\u201313.1) versus 12.5\u2009mm (IQR 9.7\u201315.4) on angiography (<jats:italic>p<\/jats:italic>\u2009=\u20090.049). Additionally, the PFO exit diameter and PFO volume were smaller in patients with successful closure than unsuccessful closure, with a mean diameter of 7.0\u2009\u00b1\u20093.1\u2009mm versus 9.5\u2009\u00b1\u20093.8\u2009mm (<jats:italic>p<\/jats:italic>\u2009=\u20090.015) and a median volume of 381\u2009mm<jats:sup>3<\/jats:sup> (IQR 286\u2013894) versus 985\u2009mm<jats:sup>3<\/jats:sup> (IQR 572\u20131550) (<jats:italic>p<\/jats:italic>\u2009=\u20090.016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our study cohort, the successful PFO closure rate using NobleStitch EL was relatively low (60%). With this alternative procedure, patients with a small PFO driven by a short PFO tunnel length and small exit diameter seem to be eligible for successful suture\u2010based closure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30691","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T07:30:52Z","timestamp":1684913452000},"page":"273-280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Anatomical predictors for suture\u2010based closure of the patent foramen ovale: A multicenter experience"],"prefix":"10.1002","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0159-0754","authenticated-orcid":false,"given":"Lars S.","family":"Witte","sequence":"first","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1997-1918","authenticated-orcid":false,"given":"Mick P. L.","family":"Renkens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences University of Amsterdam Amsterdam The Netherlands"},{"name":"Department of Cardiology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"G\u0105secka","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Centre Utrecht Utrecht The Netherlands"},{"name":"1st Chair and Department of Cardiology Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelhak","family":"el Bouziani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbert J.","family":"de Winter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan G. P.","family":"Tijssen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter R.","family":"Stella","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0122-5397","authenticated-orcid":false,"given":"Gregor","family":"Leibundgut","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cantonal Hospital Baselland Liestal Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Voskuil","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy649"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1705915"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1610057"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707404"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.046"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-18-00023"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz157"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.054305"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-21-00242"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-21-01021"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.repc.2021.08.015"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301440"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.06.004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009639"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211716"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.03.008"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-3583"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.30691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T07:45:33Z","timestamp":1692344733000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.30691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,24]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/ccd.30691"],"URL":"https:\/\/doi.org\/10.1002\/ccd.30691","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,24]]},"assertion":[{"value":"2022-12-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}