scholarly journals Patent Foramen Ovale in Fetal Life, Infancy and Childhood

2020 ◽  
Vol 8 (3) ◽  
pp. 25
Author(s):  
Bibhuti B. Das
Keyword(s):  
Patent Foramen Ovale ◽  
Life Support ◽  
Decompression Sickness ◽  
Cryptogenic Stroke ◽  
Anatomical Variations ◽  
Fetal Life ◽  
Foramen Ovale ◽  
Ventricular Assist ◽  
Echocardiographic Finding ◽  
Diagnostic Modalities

A patent foramen ovale (PFO) is a common, incidental echocardiographic finding in otherwise healthy and asymptomatic infants and children. However, a variety of clinical conditions have been ascribed to the presence of a PFO in childhood, such as cryptogenic stroke, platypnea-orthodeoxia syndrome, decompression sickness and migraine, although the data on these are controversial and sometimes contradictory. This review discusses embryology and correlation with post-natal anatomy, anatomical variations of the atrial septum, diagnostic modalities in special circumstances of PFO associated clinical syndromes, and the role of PFO in congenital heart disease, pulmonary hypertension, dilated cardiomyopathy and heart failure in children who require an extracorporeal membrane oxygenator or ventricular assist device as life support.

Current status of transcatheter closure of patent foramen ovale

2020 ◽  
Vol 128 (3) ◽  
pp. 296-306
Author(s):  
Igor F. Palacios
Keyword(s):  
Transcranial Doppler ◽  
Patent Foramen Ovale ◽  
Decompression Sickness ◽  
Adult Population ◽  
Cryptogenic Stroke ◽  
Current Status ◽  
Diagnostic Tools ◽  
Foramen Ovale ◽  
Exercise Induced ◽  
Ischemic Attack

A patent foramen ovale (PFO) is a highly prevalent structure among the adult population. It allows the shunt of blood through the inter-atrial septum and has been associated with cryptogenic stroke, transient ischemic attack, significant right to left shunting resulting in resting and exercise-induced hypoxemia, platypnea orthodeoxia syndrome, and decompression sickness after scuba diving and migraines. Currently, transthoracic and transesophageal echocardiography and transcranial Doppler are the most important diagnostic tools, for the diagnosis of PFO. The sensitivity and specificity of the study depend on the modalities available: transthoracic (TTE), transesophageal (TEE), and transcranial Doppler (TCD), as well as the intravenous use of agitated saline and the site of injection.

scholarly journals Patent Foramen Ovale Closure: State of the Art

2020 ◽  
Vol 15 ◽  
Author(s):  
Joel P Giblett ◽  
Lynne K Williams ◽  
Stephen Kyranis ◽  
Leonard M Shapiro ◽  
Patrick A Calvert
Keyword(s):  
Patent Foramen Ovale ◽  
Decompression Sickness ◽  
Recurrent Stroke ◽  
Adult Population ◽  
Cryptogenic Stroke ◽  
Foramen Ovale ◽  
Arterial Circulation ◽  
Arterial Embolisation ◽  
Randomised Control Trials ◽  
Paradoxical Embolus

Patent foramen ovale (PFO) is a common abnormality affecting between 20% and 34% of the adult population. For most people, it is a benign finding; however, in some people, the PFO can open widely to enable paradoxical embolus to transit from the venous to arterial circulation, which is associated with stroke and systemic embolisation. Percutaneous closure of the PFO in patients with cryptogenic stroke has been undertaken for a number of years, and a number of purpose-specific septal occluders have been marketed. Recent randomised control trials have demonstrated that closure of PFO in patients with cryptogenic stroke is associated with reduced rates of recurrent stroke. After a brief overview of the anatomy of a PFO, this article considers the evidence for PFO closure in cryptogenic stroke. The article also addresses other potential indications for closure, including systemic arterial embolisation, decompression sickness, platypnoea–orthodeoxia syndrome and migraine with aura. The article lays out the pre-procedural investigations and preparation for the procedure. Finally, the article gives an overview of the procedure itself, including discussion of closure devices.

scholarly journals Update on the Management of Patent Foramen Ovale in 2017: Indication for Closure and Literature Review

2017 ◽  
Vol 11 (2) ◽  
pp. 75 ◽  
Author(s):  
Kimberly Atianzar ◽  
Peter Casterella ◽  
Ming Zhang ◽  
Rahul Sharma ◽  
Sameer Gafoor ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Patent Foramen Ovale ◽  
Randomized Clinical Trials ◽  
Decompression Sickness ◽  
Cryptogenic Stroke ◽  
Closure Device ◽  
Foramen Ovale ◽  
Stroke Patients ◽  
Consensus Statements ◽  
Pfo Closure

Patent foramen ovale (PFO) is a common congenital abnormality with a high prevalence of approximately 25 % in the general population and an even higher incidence of about 40 % in the cryptogenic stroke population. PFO closure in cryptogenic stroke patients as a treatment modality for the secondary prevention of recurrent stroke has been much debated and studied. Several completed randomized clinical trials sought to answer the question of whether PFO closure is beneficial for cryptogenic stroke patients. Until the most recent of these trials, no significant benefit had been demonstrated. Based on newer evidence, in October 2016 the US Food and Drug Administration approved the first dedicated closure device for PFO. This review article describes the association between PFO and cryptogenic stroke, reviews current diagnostic modalities of PFO assessment, discusses management approaches, and reviews randomized clinical trials, practice guidelines, and consensus statements. Associations between PFO and other conditions such as migraine headaches, platypnea-orthodeoxia syndrome, and decompression sickness in divers are also briefly reviewed.

scholarly journals Patent Foramen Ovale Closure in 2019

2019 ◽  
Vol 14 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Joel P Giblett ◽  
Omar Abdul-Samad ◽  
Leonard M Shapiro ◽  
Bushra S Rana ◽  
Patrick A Calvert
Keyword(s):  
Patent Foramen Ovale ◽  
Decompression Sickness ◽  
Recurrent Stroke ◽  
Adult Population ◽  
Cryptogenic Stroke ◽  
Foramen Ovale ◽  
Arterial Circulation ◽  
Paradoxical Embolus ◽  
Randomised Controlled ◽  
Pfo Closure

Patent foramen ovale (PFO) is a common abnormality affecting between 20% and 34% of the adult population. For most people it is a benign finding; however, in some the PFO can open widely, enabling a paradoxical embolus to transit from the venous to arterial circulation, which is associated with stroke and systemic embolisation. Percutaneous closure of PFO in patients with cryptogenic stroke has been undertaken for a number of years, and a number of purpose-specific septal occluders have been marketed. Recent randomised controlled trials have demonstrated that closure of PFO in patients with cryptogenic stroke is associated with reduced rates of recurrent stroke. After a brief overview of the anatomy of a PFO, this review considers the evidence for PFO closure in cryptogenic stroke. The review also addresses other potential indications for closure, including systemic embolisation, decompression sickness, platypnoea–orthodeoxia syndrome and migraine with aura. It lays out the pre-procedural investigations and preparation for the procedure. Finally, it gives an overview of the procedure itself, including discussion of closure devices.

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

2011 ◽  
Vol 6 (1) ◽  
pp. 67
Author(s):  
Antonio L Bartorelli ◽  
Claudio Tondo ◽  
◽  
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.

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

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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