Why PFO Closure is an Exciting Therapy Megan Coylewright, MD MPH Interventional Cardiology Associate Director, Structural Heart Disease Program Dartmouth-Hitchcock Medical Center
Disclosures • Edwards LifeSciences • Boston Scientific • Gore
PFO closure today • Case • Multiple RCTs with proven efficacy • Predictable and safe procedure • Excellent reimbursement
• 60 year old man with small left parietal infarction of unclear etiology, full recovery • Hypertension • Brief tobacco use • Neuro partner refers for PFO closure
• No history cancer, personal clot or first degree relative or autoimmune disease • CTA negative for atherosclerotic or other vessel disease • Zio negative for atrial fibrillation • Imaging demonstrates a high risk PFO (atrial septal aneurysm) • Started statin, stopped as he feels he “doesn’t need it”
PFO closure today • Case • Multiple RCTs with proven efficacy • Predictable and safe procedure • Excellent reimbursement
PFO closure today • Case • Multiple RCTs with proven efficacy • Predictable and safe procedure • Excellent reimbursement
PFO closure is a safe procedure with low rate of device related SAEs REDUCE Study Data 1 RESPECT Study Data 2 Device – or procedure-related SAE 3.6% 4.2% Device-related SAE 1.4% 2.6% Procedure-related SAE 2.5% 2.4% Short procedure and down time for patients is minimal Total Length of procedure Back to Strenuous Activities 1-2 hours 2 weeks
PFO closure today • Case • Multiple RCTs with proven efficacy • Predictable and safe procedure • Excellent reimbursement
Reimbursement Physician Reimbursement • CPT Code - 93580 - Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant - $1025.31 • wRVU – 17.97 Hospital Outpatient • HCPCS/CPT Code – 93580 - $16,020 Hospital Inpatient • ICD – 10 – PCS – 02U53JZ – MS-DRG- 273 - $21,569 • ICD – 10 – PCS – 02U54JZ – MS – DRG – 274 - $16,684
https://www.bmj.com/conten t/362/bmj.k2515/infographic
Megan Coylewright, MD MPH Interventional Cardiology Associate Director, Structural Heart Disease Program Dartmouth-Hitchcock Medical Center megan.coylewright@hitchcock.org
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