Featured Case | Successful Closure of PFO with Multifenestrated ASD and ASA Using D-shufo®'s Innovative Asymmetric Disc Design

Time:

2024-08-03

Patient Profile

A 49-year-old female presented with recurrent headaches over one year, partially relieved by analgesics. Symptoms worsened in the past month with refractory pain. Transesophageal echocardiography (TEE) revealed:

Complex Septal Anatomy:Double-layer structure superior to fossa ovalis;PFO tunnel: 9.0 mm length, 1.0 mm slit diameter;Attenuated mid-septum bulging into RA (12 mm width × 6.0 mm depth);Two flow interruptions in the aneurysm with left-to-right shunting (2.1 mm and 1.5 mm jets).

Agitated Saline Contrast: Grade III RLS

Diagnosis: PFO with multifenestrated ASD and atrial septal aneurysm (ASA)

Occlusion Strategy

Conventional occluders were unsuitable:

PFO devices → Inadequate coverage for multifenestrated defects

ASD devices → Oversized waist incompatible with anatomy

Solution: D-shufo® PFO Occluder,Unique asymmetric design (larger left disc, smaller right disc)

Specifically engineered for PFO + fenestrated ASD closure

Device Selected: D-shufo® 30/24-6 mm

Delivered via 10F Astross Delivery System

Procedure

Performed under local anesthesia via femoral access:Crossing: Astross system’s Swartz-style curved tip provided:Anatomical coaxial alignment,Single-attempt septal crossing.

释放左盘面

Deployment:Left disc release: Anchor-free design → flatter profile for accelerated endothelialization,Right disc deployment: Precise apposition to septal aneurysm.

释放右盘面

牵拉试验

超声下显示贴合良好，未影响瓣膜及周围组织，无残余分流Verification:

Tug test confirmed stability,TEE showed:Zero residual shunt,No impingement on valvular structures

释放封堵器，DSA下观察，形态良好，手术过程仅15分钟

Efficiency: Procedure completed in 15 minutes

Postoperative Echo:

Occluder well-positioned with optimal morphology; no interatrial shunt.

Clinical Insight

Traditional occluders often fail in complex PFO-ASD-ASA anatomies, risking residual shunts and hemodynamic compromise. The D-shufo® occluder addresses this through:

Purpose-built asymmetric architecture (30/24-6 & 36/24-6 sizes),Comprehensive defect coverage in a single-device solution,Proven efficacy where conventional devices underperform.The optimal choice for challenging septal pathologies – delivering complete closure where others cannot.

专家简介