Suture-based PFO closure is a catheter-based technique that closes the patent foramen ovale without leaving a permanent implant in the heart. The septal tissue is approximated using sutures rather than an occluder device.
This approach is fundamentally different from device-based or bioresorbable closure techniques.
Why suture-based PFO closure may be considered
Suture-based PFO closure may be considered in selected patients, particularly:
– Patients with known or suspected nickel allergy
– Patients who wish to avoid a permanent intracardiac implant
– Patients with concerns about long-term device-related issues
– Selected patients with suitable PFO anatomy
Patient selection is based on detailed anatomical assessment and individualized clinical evaluation.
Residual shunt considerations
A residual shunt after implantation of a conventional metal PFO device cannot be treated with suture-based closure.
However, a residual shunt after suture-based PFO closure can be further treated using a bioresorbable closure concept. This scenario is particularly relevant in patients with nickel allergy.
Advantages and appropriate use
Suture-based PFO closure avoids a permanent implant and preserves access to the left atrium, which may be relevant in selected patients who require future procedures.
At the same time, suture-based techniques are not suitable for all PFO anatomies. In some cases, device-based or bioresorbable closure strategies may provide a more predictable result. Technique selection is always individualized.
Follow-up and expectations
As with all PFO closure strategies, careful follow-up imaging is required to confirm closure success and to guide further management if residual shunting is detected.
Treatment decisions are based on anatomy, clinical context, and long-term planning.