scholarly journals Doppler ultrasound assessment of minor atrial septal defects in patients with paradoxical embolism

2021 ◽  
Vol 15 (4) ◽  
pp. 86-92
Author(s):  
Alina R. Karshieva ◽  
Andrey O. Chechetkin ◽  
Anastasia V. Belopasova ◽  
Larisa A. Dobrynina
Keyword(s):  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
Septal Defects ◽  
Clinical Observations ◽  
Scientific Papers ◽  
Ultrasound Assessment ◽  
The Relationship ◽  
The Brain

Minor atrial septal defect (ASD) may be one of the pathways of paradoxical embolism in the brain. Few scientific papers have investigated the relationship between ASD (excluding patent foramen ovale) and the occurrence of ischemic stroke. There is no definite opinion as to how functionally important such shunts are and how the shunt changes with age. The review analyzes modern ideas about the probability of paradoxical embolism in small ASDs from the viewpoint of pathophysiology, and also demonstrates the technological capabilities of assessing the functional significance of such shunts based on our own clinical observations.

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.

Atrial septal defects (ASDs)

2011 ◽  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Atrial Septal Defect ◽  
Coronary Sinus ◽  
Patent Foramen Ovale ◽  
Congenital Heart ◽  
Septal Defect ◽  
Foramen Ovale ◽  
Septal Defects ◽  
Different Types

Introduction 94Ostium secundum ASD 96Ostium primum ASD 100Sinus venosus ASD 100Coronary sinus defect 102Patent foramen ovale 104Interatrial communications account for ~10% of congenital heart disease. Different types of atrial septal defect (ASD) are illustrated in Fig. 8.1.•...

scholarly journals Patent Foramen Ovale and Cryptogenic Stroke: Challenges in Diagnosis and Management

2021 ◽  
Vol 42 (3) ◽  
Author(s):  
Dhanang Ali Yafi ◽  
Azmi Azmi
Keyword(s):  
Patent Foramen Ovale ◽  
Adult Population ◽  
Management Strategies ◽  
Cryptogenic Stroke ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
Arterial Circulation ◽  
Systemic Embolization ◽  
The Relationship ◽  
Pfo Closure

A patent foramen ovale (PFO) is a common disorder that affects between 20-34% of the adult population. This condition is a benign finding for most people. However, In some the PFO can open widely and enabling paradoxical embolism to transit from venous to arterial circulation, which is associated with stroke and systemic embolization. There are still unclear to date regarding the effectiveness of pharmacological anticoagulant therapy, defined as antithrombin or antiplatelet therapy, which has proven to be more beneficial for patients with PFO and cryptogenic stroke. In addition, surgical and transcutaneous PFO closure has been proposed for secondary prevention of stroke in patients with cryptogenic stroke with PFO. Both catheter-based and surgical modes of closure have been shown to reduce the incidence of subsequent embolism substantially. This review will discuss the evidence regarding the relationship between PFO and cryptogenic stroke and decision making for management strategies.

scholarly journals Incidental diagnosis of four pulmonary arteriovenous fistulas during patent foramen ovale closure: a case report

2020 ◽  
Vol 30 (9) ◽  
pp. 1363-1365
Author(s):  
Alessandro Andreis ◽  
Gabriella Agnoletti ◽  
Paolo Scacciatella
Keyword(s):  
Patent Foramen Ovale ◽  
Clinical Case ◽  
Septal Defect ◽  
Cryptogenic Stroke ◽  
Young Patients ◽  
Transoesophageal Echocardiography ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
Arteriovenous Fistulas ◽  
Pulmonary Arteriovenous Fistulas

AbstractCryptogenic cerebral ischemia in young patients is commonly ascribed to paradoxical embolism. We report the clinical case of a young patient with cryptogenic stroke and a patent foramen ovale, undergoing percutaneous closure of atrial septal defect. Contrast transoesophageal echocardiography at the end of the procedure demonstrated massive late residual right-to-left shunt, due to the coexistence of pulmonary arteriovenous fistulas that were subsequently closed. Routinary adoption of contrast transoesophageal echocardiography at the end of patent foramen ovale closure interventions may be useful to detect early and late residual shunts. Late residual shunts may be due to pulmonary fistulas, a well-known risk factor for recurrent thromboembolic events.

Different Patent Foramen Ovale Morphology and Accompanying Atrial Septal Defect as a Cause of Paradoxical Embolism

2018 ◽  
Vol 121 (8) ◽  
pp. e30
Author(s):  
Begüm Yetiş Sayın ◽  
Sercan Okutucu ◽  
Hakan Aksoy ◽  
Vahide Şimşek ◽  
Ebru Akgül Ercan ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Paradoxical Embolism ◽  
Foramen Ovale

Percutaneous Transcatheter Closure of Interatrial Septal Defect in Adults – A Review

2011 ◽  
Vol 6 (2) ◽  
pp. 173
Author(s):  
Joelle Kefer ◽  
Keyword(s):  
Atrial Septal Defect ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Foramen Ovale ◽  
Secundum Atrial Septal Defect ◽  
Septal Defects ◽  
Device Implantation ◽  
Number Of Patients ◽  
Pfo Closure

Atrial septal abnormalities are common congenital lesions remaining asymptomatic until adulthood in a great number of patients. The most frequent atrial septal defects in adults are ostium secundum atrial septal defect (ASD) and patent foramen ovale (PFO), both approachable by transcatheter closure using device implantation. The article reviews the different devices available, the technique of implantation and the indications for transcatheter ASD and PFO closure.

scholarly journals STROKE AND ATRIAL SEPTAL DEFECTS – DECISION MAKING AT THE TURNING OF AGES

2017 ◽  
Vol 16 (3) ◽  
pp. 101-108
Author(s):  
Vlad Eugen Tiu ◽  
◽  
Athena Ribigan ◽  
Raluca Badea ◽  
Ovidiu Bajenaru ◽  
...  
Keyword(s):  
Decision Making ◽  
Atrial Septal Defect ◽  
Young Patient ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Embolic Stroke ◽  
Evidence Based ◽  
Foramen Ovale ◽  
Septal Defects ◽  
Evidence Based Decision Making

CLOSE and Gore-REDUCE trials have recently changed the way we approach patients with stroke and patent foramen ovale. We present the case of a young patient with an Embolic Stroke of Undetermined Source (ESUS) and an atrial septal defect causing a large right-to-left shunt, with an ample discussion on evidence-based decision making.

Transcatheter Amplatzer Device Closure of Atrial Septal Defect and Patent Foramen Ovale in Patients With Presumed Paradoxical Embolism

2004 ◽  
Vol 79 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Anant Khositseth ◽  
Allison K. Cabalka ◽  
John P. Sweeney ◽  
F. David Fortuin ◽  
Guy S. Reeder ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
Device Closure ◽  
Amplatzer Device

Caught in the Act: Impending Paradoxical Embolism

2002 ◽  
Vol 10 (4) ◽  
pp. 342-343 ◽  
Author(s):  
Alex M Fabricius ◽  
Martin Krüger ◽  
Michaela Hanke ◽  
Friedrich W Mohr
Keyword(s):  
Pulmonary Embolism ◽  
Atrial Septal Defect ◽  
Transesophageal Echocardiography ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
Recurrent Pulmonary Embolism ◽  
Systemic Anticoagulation ◽  
Residual Thrombus

In a 73-year-old woman admitted with pulmonary embolism, a thrombus wedged across a patent foramen ovale was revealed by transesophageal echocardiography. After systemic anticoagulation, cardiac embolectomy and closure of the atrial septal defect were considered. Before surgery, repeat transesophageal echocardiography revealed only a small patent foramen ovale with no residual thrombus. We assumed dissolution of the thrombus as the patient had no sign of systemic or recurrent pulmonary embolism.

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