ArticleJournal of the Society for Cardiovascular Angiography & Interventions2026
Beyond Tunnel Length: Tunnel Width-Derived Cover Index Improves Device Sizing and Predicts Outcomes After Transcatheter Patent Foramen Ovale Closure.
Article in Journal of the Society for Cardiovascular Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Residual shunting after transcatheter patent foramen ovale (PFO) closure occurs in up to 25% of patients and increases the risk of recurrent neurologic events. Existing sizing strategies may be insufficient as they overlook the tunnel's complex 3-dimensional (3D) anatomy. The aim of this study was to evaluate PFO tunnel dimensions with 3D transesophageal echocardiography (TEE) and determine whether tunnel width (TW) metrics would predict procedural outcomes. Methods: We retrospectively analyzed 102 patients undergoing PFO closure (n = 82 with follow-up bubble study). 3D-TEE was used to assess TW at right (TW Results: Tunnel length did not correlate with TW Conclusions: Despite its widespread use for sizing, tunnel length is unrelated to TW, septal excursion, or procedural outcomes after PFO closure. In contrast, TW-based metrics reliably predict outcomes, underscoring their potential to refine sizing strategies in patients undergoing this procedure.
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