Combined intracardiac echocardiography and pressure-sensing catheter for complex PFO closure: a case report

BackgroundWhile transcatheter closure of a patent foramen ovale (PFO) is usually technically feasible, certain anatomical subtypes such as long-tunnel PFOs can present considerable challenges. Due to the difficulty in advancing the guidewire through the elongated and tortuous tunnel, interventional...

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Main Authors: Rui Yan, Xiaofang Li, Jun Li, Xin Shao, Anxin Zhang, Liping Guo, Fanqi Li, Haixiong Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1623207/full
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author Rui Yan
Xiaofang Li
Jun Li
Xin Shao
Anxin Zhang
Liping Guo
Fanqi Li
Haixiong Wang
author_facet Rui Yan
Xiaofang Li
Jun Li
Xin Shao
Anxin Zhang
Liping Guo
Fanqi Li
Haixiong Wang
author_sort Rui Yan
collection DOAJ
description BackgroundWhile transcatheter closure of a patent foramen ovale (PFO) is usually technically feasible, certain anatomical subtypes such as long-tunnel PFOs can present considerable challenges. Due to the difficulty in advancing the guidewire through the elongated and tortuous tunnel, interventional cardiologists often have to resort to transseptal puncture. However, transseptal puncture is associated with a higher incidence of postoperative residual shunts and an increased risk of puncture-related complications. In this case report, we describe for the first time a novel approach that combines intracardiac echocardiography (ICE) with a pressure-sensing catheter to facilitate guidewire advancement during the PFO procedure. We refer to this innovative technique as the “push and easy” method. This approach offers a promising solution for the closure of complex long-tunnel PFOs while minimizing radiation exposure during the procedure.Case summaryA 20-year-old male patient with a complex long-tunnel PFO was referred to our center. Initial attempts to visualize and traverse the PFO using ICE alone were unsuccessful due to the tunnel's excessive length and tortuosity. Consequently, a pressure-sensing catheter was introduced. This catheter, offering real-time pressure feedback along with enhanced support and maneuverability, enabled successful guidewire passage through the PFO. Under the combined guidance of ICE and the pressure-sensing catheter, precise and safe closure of the complex PFO was achieved, without any radiation exposure. We refer to this novel, radiation-free approach as the “push and easy” technique, which may offer a valuable option for the management of complex long-tunnel PFOs.
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spelling doaj-art-a0269d04efeb4019aa534b44b11591d62025-08-20T02:50:29ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.16232071623207Combined intracardiac echocardiography and pressure-sensing catheter for complex PFO closure: a case reportRui Yan0Xiaofang Li1Jun Li2Xin Shao3Anxin Zhang4Liping Guo5Fanqi Li6Haixiong Wang7Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, ChinaDepartment of Digestive Oncology, Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, ChinaDepartment of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, ChinaDepartment of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, ChinaDepartment of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, ChinaBackgroundWhile transcatheter closure of a patent foramen ovale (PFO) is usually technically feasible, certain anatomical subtypes such as long-tunnel PFOs can present considerable challenges. Due to the difficulty in advancing the guidewire through the elongated and tortuous tunnel, interventional cardiologists often have to resort to transseptal puncture. However, transseptal puncture is associated with a higher incidence of postoperative residual shunts and an increased risk of puncture-related complications. In this case report, we describe for the first time a novel approach that combines intracardiac echocardiography (ICE) with a pressure-sensing catheter to facilitate guidewire advancement during the PFO procedure. We refer to this innovative technique as the “push and easy” method. This approach offers a promising solution for the closure of complex long-tunnel PFOs while minimizing radiation exposure during the procedure.Case summaryA 20-year-old male patient with a complex long-tunnel PFO was referred to our center. Initial attempts to visualize and traverse the PFO using ICE alone were unsuccessful due to the tunnel's excessive length and tortuosity. Consequently, a pressure-sensing catheter was introduced. This catheter, offering real-time pressure feedback along with enhanced support and maneuverability, enabled successful guidewire passage through the PFO. Under the combined guidance of ICE and the pressure-sensing catheter, precise and safe closure of the complex PFO was achieved, without any radiation exposure. We refer to this novel, radiation-free approach as the “push and easy” technique, which may offer a valuable option for the management of complex long-tunnel PFOs.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1623207/fullno.18Yifen streetTaiyuan cityShanxi provinceChina no.99Longchengda street
spellingShingle Rui Yan
Xiaofang Li
Jun Li
Xin Shao
Anxin Zhang
Liping Guo
Fanqi Li
Haixiong Wang
Combined intracardiac echocardiography and pressure-sensing catheter for complex PFO closure: a case report
Frontiers in Cardiovascular Medicine
no.18
Yifen street
Taiyuan city
Shanxi province
China no.99
Longchengda street
title Combined intracardiac echocardiography and pressure-sensing catheter for complex PFO closure: a case report
title_full Combined intracardiac echocardiography and pressure-sensing catheter for complex PFO closure: a case report
title_fullStr Combined intracardiac echocardiography and pressure-sensing catheter for complex PFO closure: a case report
title_full_unstemmed Combined intracardiac echocardiography and pressure-sensing catheter for complex PFO closure: a case report
title_short Combined intracardiac echocardiography and pressure-sensing catheter for complex PFO closure: a case report
title_sort combined intracardiac echocardiography and pressure sensing catheter for complex pfo closure a case report
topic no.18
Yifen street
Taiyuan city
Shanxi province
China no.99
Longchengda street
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1623207/full
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