Abstract 4120246: PFO Device Complications: Literature Review and Possible Implications for Echocardiographic Follow-up

Introduction: Transthoracic (TTE) guidelines after PFO device closure are vague. Goal: To perform a literature search to characterize the type, frequency, and timing of complications that occur after PFO device placement to determine the utility of routine TTE in post-device patients. Methods: A search was performed in Medline (PubMed) with English language and publication date (2000-2023) filters applied. Studies were included if they reported on PFO device closures. If a study included both PFO and ASD device closures with no distinction between the groups, it was included. Studies were excluded if it only reported on ASD device closures, were meta-analysis/review papers, or did not report any outcomes for the PFO device procedure. Results: Total of 305 articles met criteria. Incidence of complications was 6.9% (3358/48348). Maximum range of follow-up was 0 – 17 years. Types and timing of complications presented in Tables 1 and 2. Majority of complications occurred < 6 months (57.8%, 1941/3358) with only 0.8% (27/3358) occurring > 5 years post-device. All patients with complications > 5 years device placement presented with clinical symptoms related to their complications. Conclusion: Incidence of complications after PFO device placement appeared to significantly decrease 5 years post-procedure. Late complications were all preceded by clinical symptoms. Routine use of TTE < 5 years post-device may be reasonable, but > 5 years, TTE may only be needed if clinical symptoms occur.