scholarly journals Transcatheter treatment of atrial septal aneurysm associated with patent foramen ovale for prevention of recurrent paradoxical embolism in high-risk patients

2005 ◽  
Vol 45 (3) ◽  
pp. 377-380 ◽  
Author(s):  
Andreas Wahl ◽  
Bernhard Meier ◽  
Markus Schwerzmann ◽  
Ulf Becker ◽  
Christian Seiler ◽  
...  
Keyword(s):  
High Risk ◽  
Patent Foramen Ovale ◽  
Paradoxical Embolism ◽  
Atrial Septal Aneurysm ◽  
Foramen Ovale ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Echocardiography Detection of High-Risk Patent Foramen Ovale Morphology

2021 ◽  
Vol 42 (3) ◽  
Author(s):  
Amiliana M Soesanto
Keyword(s):  
High Risk ◽  
Patent Foramen Ovale ◽  
Observational Studies ◽  
Technical Information ◽  
Paradoxical Embolism ◽  
Foramen Ovale

Patent Foramen Ovale occurs in 25% of the general population1. Several studies suggested that paradoxical embolism through a patent foramen ovale (PFO) correlate with cryptogenic strokes (CS). Many epidemiological and clinical observational studies, showed the association between CS and the presence of PFO.  There is still a controversy whether PFO should be closed. The information about PFO morphology might be useful for the management of PFO. This article is discussing a technical information about how echocardiography detects PFO and identifies high risk morphologies for the occurrence of PFO related -stroke.

scholarly journals Low-Angle Patent Foramen Ovale (PFO): High-Risk PFO Morphology Associated with Paradoxical Embolism

CASE ◽  
2021 ◽  
Author(s):  
Rie Nakayama ◽  
Yoichi Takaya ◽  
Teiji Akagi ◽  
Takashi Miki ◽  
Koji Nakagawa ◽  
...  
Keyword(s):  
High Risk ◽  
Patent Foramen Ovale ◽  
Paradoxical Embolism ◽  
Foramen Ovale

scholarly journals Case report: Thrombus in transit—a cause of impending paradoxical embolism

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Rodrigo Nuñez ◽  
Jesus A Sanchez ◽  
Salvador Berber ◽  
Felipe Loaiza ◽  
Jose G Nuñez ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Risk Stratification ◽  
Patent Foramen Ovale ◽  
Clinical Symptoms ◽  
Favourable Outcome ◽  
Haemodynamic Instability ◽  
Foramen Ovale ◽  
Risk Patients ◽  
In Transit

Abstract Background A thrombus in transit (TIT) is a life-threatening condition associated with pulmonary embolism (PE). While TIT was once considered a rare diagnosis, its emergence has risen in recent years mainly through advancement in medical technology. Rare cases of a thrombus in transit crossing a patent foramen ovale in the context of pulmonary embolism have been reported. The appropriate treatment of patients in this setting remains unclear. Case summary We describe a 64-year-old man who presented with syncope to the emergency room secondary to acute pulmonary embolism. Initial transthoracic echocardiogram revealed a large intracardiac thrombus in transit across a patent foramen ovale, verified by transoesophageal echocardiogram. He underwent anticoagulation and urgent surgical thrombectomy with a favourable outcome. Discussion Risk stratification of patient with acute PE is mandatory for determining the appropriate therapeutic management. Initial risk stratification is based on clinical symptoms and signs of haemodynamic instability which indicate a high risk or early death associated massive PE. Thrombolytic therapy is indicated in high-risk patients (Grade 1B), while anticoagulation alone is recommended for intermediate-high- to low-risk patients. Assessment for intracardiac thrombi in PE modifies the treatment strategy in case of a thrombus in transit.

scholarly journals Safety and efficacy of endovascular patent foramen ovale closure: the first results of a Russian multicenter study

2020 ◽  
Vol 12 (6) ◽  
pp. 26-32
Author(s):  
D. V. Ognerubov ◽  
A. S. Tereshchenko ◽  
A. N. Samko ◽  
G. К. Arutyunyan ◽  
O. A. Sivakova ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Young Patients ◽  
Paradoxical Embolism ◽  
Atrial Septal Aneurysm ◽  
Foramen Ovale ◽  
History Of ◽  
Pfo Closure

Patent foramen ovale (PFO) is detectable in more than 25% of the adult population and is generally clinically insignificant. However, it can be a cause of paradoxical embolism in some cases. Randomized trials indicate that endovascular PFO closure in patients with a history of cryptogenic stroke is an effective method for the secondary prevention of catastrophic brain damage.Objective: to study the safety and efficiency of endovascular PFO closure in young patients with a history of cryptogenic stroke.Patients and methods. Sixty-two patients, including (22 males and 40 females) women, underwent percutaneous PFO closure in May 2018 to March 2020. The patients' mean age was 37.4±7.6 years. The inclusion criteria were a prior cryptogenic ischemic stroke lasting less than 12 months and PFO with a high risk for paradoxical embolism (PFO concurrent with atrial septal aneurysm or hypermobility; PFO, ≥2 mm size; the presence of the Chiari network and/or the Eustachian valve).Results and discussion. The technical success of the operation was achieved in all cases. In 50 (80.6%) patients, the right chamber of the heart was completely isolated from the left one in the first 3 months. During the first year, the atria were also completely isolated in 10 (16.1%) patients. A left-to-right shunt persisted in 2 (3.2%) patents 12 months later. Two patients were found to have main procedural complications: one had perioperative atrial fibrillation and the other had pseudoaneurysm formation at the puncture site.Conclusion. Endovascular PFO closure is a safe and effective operation for the secondary prevention of recurrent ischemic stroke. In our study, blood shunting through the PFO was stopped in 96.6% of patients at less than 6 months after surgery, which suggests that there is a rapid and effective reduction in the risk of paradoxical embolism.

Abstract 33: PFO in Cryptogenic Stroke: An Analysis of “High Risk” Features on Transesophageal Echocardiography in the Risk of Paradoxical Embolism Database

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Benjamin Wessler ◽  
David E Thaler ◽  
Marco R Di Tullio ◽  
Robin Ruthazer ◽  
Christian Weimar ◽  
...  
Keyword(s):  
High Risk ◽  
Cohort Studies ◽  
Transesophageal Echocardiography ◽  
Patent Foramen Ovale ◽  
Imaging Techniques ◽  
Cryptogenic Stroke ◽  
Paradoxical Embolism ◽  
Attributable Fraction ◽  
Foramen Ovale ◽  
Additional Imaging

Introduction: A patent foramen ovale (PFO) discovered in the setting of a cryptogenic stroke (CS) may be stroke-related or incidental. We have developed a score to stratify CS patients according to the probability that the event is attributable to a PFO (the Risk of Paradoxical Embolism (RoPE) Score), based on easily obtainable clinical and neuroradiological (but not transesophageal echocardiographic (TEE) variables. In this study, we examined whether putative “high risk” TEE features - shunt size, presence of a hypermobile septum, and presence of a right-to-left shunt at rest - vary across RoPE Score strata. Methods and Results: The RoPE Study combined existing cohort studies to create a pooled database of patients with CS and PFO. We dichotomized patients into groups and examined whether putative high risk TEE features are seen more frequently in those with “probable stroke-related” PFOs (RoPE Score of >6, estimated PFO attributable fraction 72-99%, n=637) than in those with lower RoPE Scores (<6, PFO attributable fraction 0-71%, n=657). None of the TEE features differed between the groups (large physiologic size, p=0.53; hypermobile septum, p=0.44; shunt at rest, p=0.11). Extensive additional exploratory analyses did not reveal any consistent associations between different RoPE Score strata and presumptive high risk echocardiographic features. Conclusion: We found no evidence that proposed TEE markers for “high risk” PFOs correlate with the estimated likelihood that a PFO is related to an index CS. Additional imaging tools or better standardization of imaging techniques are needed to determine whether specific anatomic features are associated with whether a discovered PFO is likely to be related to CS.

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