Patent Foramen Ovale Closure Procedure

Patent foramen ovale is strongly associated with cryptogenic stroke. Variousclinical trials has shown the association between cryptogenic stroke andincidence of undelrying patent foramen ovale, these trials also shown thedecrease of cryptogenic stroke incidence with the treatment of patentforamen ovale Lesion. In the absence of absolute contraindications, patientswith patent foramen ovale are advised to undergo closure. Preproceduralexaminations such as trans esophageal echocardiography and pretreatmentwith anticoagulants are required to prevent peri and postprocedural adverseevents. Currently, patent foramen ovale Closure can be done through apercutaneous access with minimal risk. Treatment of patent foramen ovalecan help decrease future incidences of strokes

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728 Different outcome after percutaneous closure of a patent foramen ovale or medical treatment to prevent cryptogenic stroke

European Heart Journal ◽

10.1016/s0195-668x(03)94136-4 ◽

2003 ◽

Vol 24 (5) ◽

pp. 130

Author(s):

M SCHROOTEN

Keyword(s):

Medical Treatment ◽

Patent Foramen Ovale ◽

Cryptogenic Stroke ◽

Percutaneous Closure ◽

Foramen Ovale

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Stroke Prophylaxis by Percutaneous Closure of Patent Foramen Ovale and Left Atrial Appendage

Interventional Cardiology Review ◽

10.15420/icr.2011.6.1.67 ◽

2011 ◽

Vol 6 (1) ◽

pp. 67

Author(s):

Antonio L Bartorelli ◽

Claudio Tondo ◽

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Keyword(s):

Left Atrial ◽

Patent Foramen Ovale ◽

Stroke Risk ◽

Left Atrial Appendage ◽

Cryptogenic Stroke ◽

Atrial Appendage ◽

Foramen Ovale ◽

Percutaneous Procedures ◽

Cerebrovascular Events

Innovative percutaneous procedures for stroke prevention have emerged in the last two decades. Transcatheter closure of the patent foramen ovale (PFO) is performed in patients who suffered a cryptogenic stroke or a transient ischaemic attach (TIA) in order to prevent recurrence of thromboembolic events. Percutaneous occlusion of the left atrial appendage (LAA) has been introduced to reduce stroke risk in patients with atrial fibrillation (AF). The role of PFO and LAA in the occurrence of cerebrovascular events and the interventional device-based therapies to occlude the PFO and LAA are discussed.

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Faculty Opinions recommendation of Closure or medical therapy for cryptogenic stroke with patent foramen ovale.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14267257.15779440 ◽

2012 ◽

Author(s):

Philippa Newfield

Keyword(s):

Medical Therapy ◽

Patent Foramen Ovale ◽

Cryptogenic Stroke ◽

Foramen Ovale

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Patent Foramen Ovale, the Role of Antiplatelet Therapy Alone or Anticoagulant Therapy Alone Versus Device Closure for Cryptogenic Stroke: A Review of the Literature and Current Recommendations

Cardiovascular & Hematological Agents in Medicinal Chemistry ◽

10.2174/1871525718666200203111641 ◽

2020 ◽

Vol 18 (2) ◽

pp. 135-150

Author(s):

Harsha S. Nagarajarao ◽

Chandra P. Ojha ◽

Archana Kedar ◽

Debabrata Mukherjee

Keyword(s):

Patent Foramen Ovale ◽

Cryptogenic Stroke ◽

Narrow Channel ◽

Paradoxical Embolism ◽

Current Evidence ◽

Foramen Ovale ◽

The Right ◽

The Relationship ◽

Current Guidelines

: Cryptogenic stroke and its relation to the Patent Foramen Ovale (PFO) is a long-debated topic. Recent clinical trials have unequivocally established the relationship between cryptogenic strokes and paradoxical embolism across the PFO. This slit-like communication exists in everyone before birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communication between the right and left atria in approximately 25-27% of adults. : In this review, we examine the clinical relevance of the PFO with analysis of the latest trials evaluating catheter-based closure of PFO’s for cryptogenic stroke. We also review the current evidence examining the use of antiplatelet medications versus anticoagulants for stroke prevention in those patients with PFO who do not qualify for closure per current guidelines.

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Impact on actual clinical practice of the latest evidence for percutaneous closure of patent foramen ovale associated with stroke. A single center experience

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.089 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

L Carnero Montoro ◽

M Ruiz Ortiz ◽

N Paredes Hurtado ◽

M Delgado Ortega ◽

A Rodriguez Almodovar ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Practice ◽

Patent Foramen Ovale ◽

Cryptogenic Stroke ◽

Percutaneous Closure ◽

Publication Date ◽

Foramen Ovale ◽

Complex Anatomy ◽

The Mean ◽

The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background and aims Since september 14th, 2017. Three large clinical trials demonstrated that, in selected patients, percutaneous closure of patent foramen ovale (PFO) was associated with lower recurrence in patients with cryptogenic stroke (CS). Our aim was to determine the impact of these findings on routine clinical practice in a tertiary hospital. Methods Patients with percutaneous closure of PFO due to CS (January 2001-January 2020) were included. The clinical characteristics were analyzed individually and grouped in the RoPE score, before and after the publication date. Complex anatomy (CA) defined as interatrial septum aneurysm or basal wide bubble passage was evaluated in both periods. Results 293 patients were included. The mean age was 49 ± 11 years, 15% were older than 60 years, 60% men, 26% hypertensive, 28% smokers and 7%diabetics. The median RoPEscore was 6 [p25-75, 5-7] and 75% met CA criteria. Since september 14th, 2017, the frequency of CA and the mean age of the patients were significantly higher (89% vs. 69% p <0.0005 and 51 ± 11 vs. 48 ± 11 years, p = 0.02, respectively), and RoPEscore, significantly lower (5 [5-7] vs. 6 [5-7], p = 0.02). Conclusion The publication of clinical trials wich demonstrated the benefit of percutaneous closure of PFO in CS had a significant impact on the daily clinical practice of our institution, with an increase in indications for CA, despite a clinical profile suggestive of lower causal probability of PFO.

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