{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:00:22Z","timestamp":1747184422294,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T00:00:00Z","timestamp":1685318400000},"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":["Echocardiography"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Percutaneous closure of patent foramen ovale (PFO) is conventionally performed under continuous transesophageal echocardiographic (TEE) guidance. We aimed to evaluate whether a simplified procedural approach, including pure fluoroscopy\u2010guidance and final TEE control, as well as an aimed \u2018next\u2010day\u2010discharge\u2019 is comparable with the conventional TEE\u2010guided procedure in terms of periprocedural and intermediate\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent a PFO closure at our center between 2010 and 2022 were retrospectively included. Prior to June 2019 cases were performed with continuous TEE guidance (TEE\u2010guided group). Since June 2019, only pure fluoroscopy\u2010guided PFO closures have been performed with TEE insertion and control just prior to device release (fluoroscopy\u2010guided group). We analyzed procedural aspects, as well as long term clinical and echocardiographic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total 291 patients were included in the analysis: 197 in the TEE\u2010guided group and 94 in the fluoroscopy\u2010guided group. Fluoroscopy\u2010guided procedures were markedly shorter (48\u00a0\u00b1\u00a020 min vs. 25\u00a0\u00b1\u00a09 min; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01). There was no difference in procedural complications, including death, major bleeding, device dislodgement, stroke or clinically relevant peripheral embolization between the two groups (.5% vs. 0%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.99). Hospital stay was also shorter with the simplified approach (2.5\u00a0\u00b1\u00a01.6 vs. 3.5\u00a0\u00b1\u00a01.2 days; <jats:italic>p<\/jats:italic>\u00a0&lt; .01), allowing 85% same\u2010day discharges during the last 12 months of observation period.<\/jats:p><jats:p>At 6\u00a0\u00b1\u00a03 months echocardiographic follow\u2010up a residual leakage was described in 8% of the TEE\u2010guided cases and 2% of the fluoroscopy\u2010guided cases (<jats:italic>p<\/jats:italic>\u00a0= .08).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While a complete TEE\u2010free PFO closure might have potential procedural risks, our approach of pure fluoroscopy\u2010guided with a brisk final TEE check seems to be advantageous in terms of procedural aspects with no sign of any acute or intermediate\u2010term hazard and it could offer an equitable compromise between the two worlds: a complete TEE procedure and a procedure without any TEE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15630","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T05:39:11Z","timestamp":1685425151000},"page":"657-663","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Transesophageal echocardiography\u2010guided versus fluoroscopy\u2010guided patent foramen ovale closure: A single center registry"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5540-3478","authenticated-orcid":false,"given":"Alexandru","family":"Achim","sequence":"first","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"},{"name":"\u201cNiculae Stancioiu\u201d Heart Institute University of Medicine and Pharmacy \u201cIuliu Hatieganu\u201d Cluj\u2010Napoca  Cluj\u2010Napoca Romania"},{"name":"Department of Internal Medicine Invasive Cardiology Division University of Szeged  Szeged Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Hochegger","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadeek S.","family":"Kanoun Schnur","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"},{"name":"Department of Internal Medicine Invasive Cardiology Division University of Szeged  Szeged Hungary"},{"name":"South West Peninsula Deanery University Plymouth Hospitals NHS Trust  Plymouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Moser","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosima","family":"Stark","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robertas","family":"Pranevi\u010dius","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"},{"name":"Department of Cardiology Hospital of Lithuanian University of Health and Sciences  Vilnius Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Prunea","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albrecht","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klemens","family":"Ablasser","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Verheyen","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewald","family":"Kolesnik","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olev","family":"Luha","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoltan","family":"Ruzsa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Invasive Cardiology Division University of Szeged  Szeged Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Zirlik","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabor G.","family":"Toth","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart Center Graz Medical University of Graz  Graz 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