Effect of catheter-based patent foramen ovale closure on the occurrence of arterial bubbles in scuba divers.

Honěk J, Srámek M, Sefc L, Januška J, Fiedler J, Horváth M, Tomek A, Novotný S, Honěk T, Veselka J. Journal of American College of Cardiology: Cardiovascular Interventions. 2014 Apr;7(4):403–8. doi: 10.1016/j.jcin.2013.12.199. Epub 2014 Mar 14. IF: 7.44

MUDr. Jakub Honěk

Department of Cardiology

Abstract

OBJECTIVES: This study sought to evaluate the effect of catheter-based patent foramen ovale (PFO) closure on the occurrence of arterial bubbles after simulated dives.

BACKGROUND: PFO is a risk factor of decompression sickness in divers due to paradoxical embolization of bubbles. To date, the effectiveness of catheter-based PFO closure in the reduction of arterial bubbles has not been demonstrated.

METHODS: A total of 47 divers (age 35.4 ± 8.6 years, 81% men) with a PFO (PFO group) or treated with a catheter-based PFO closure (closure group) were enrolled in this case-controlled observational trial. All divers were examined after a simulated dive in a hyperbaric chamber: 34 divers (19 in the PFO group, 15 in the closure group) performed a dive to 18 m for 80 min, and 13 divers (8 in the PFO group, 5 in the closure group) performed a dive to 50 m for 20 min. Within 60 min after surfacing, the presence of venous and arterial bubbles was assessed by transthoracic echocardiography and transcranial color-coded sonography, respectively.

RESULTS: After the 18-m dive, venous bubbles were detected in 74% of divers in the PFO group versus 80% in the closure group (p = 1.0), and arterial bubbles were detected in 32% versus 0%, respectively (p = 0.02). After the 50-m dive, venous bubbles were detected in 88% versus 100%, respectively (p = 1.0), and arterial bubbles were detected in 88% versus 0%, respectively (p < 0.01).

CONCLUSIONS: No difference was observed in the occurrence of venous bubbles between the PFO and closure groups, but the catheter-based PFO closure led to complete elimination of arterial bubbles after simulated dives. (Nitrogen Bubble Detection After Simulated Dives in Divers With PFO and After PFO Closure; NCT01854281).

http://www.ncbi.nlm.nih.gov/pubmed/24630875

Created: 11. 12. 2014 / Modified: 22. 1. 2019 / Responsible person: Mgr. Ing. Tereza Kůstková