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Patent foramen ovale and its embolic implications
S De Castro1, D Cartoni, M Fiorelli
1Department of Clinical Medicine, La Sapienza University of Rome, Italy.
The American Journal of Cardiology
|September 21, 2000
Summary
Echocardiography can identify patent foramen ovale (PFO) features, like shunting at rest and mobile membranes, that increase stroke recurrence risk. These findings aid in stratifying risk for patients with acute ischemic stroke.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Patent foramen ovale (PFO) is a potential cause of cryptogenic stroke.
- Echocardiographic assessment of PFO characteristics is crucial for risk stratification.
Purpose of the Study:
- To evaluate the utility of echocardiographic PFO features in predicting stroke recurrence.
- To identify specific PFO characteristics associated with increased risk of recurrent ischemic events.
Main Methods:
- Retrospective analysis of patients with acute ischemic stroke and PFO.
- Echocardiographic assessment for PFO presence, rest shunting, and fossa ovalis membrane mobility.
- Follow-up for recurrent stroke or transient ischemic attack (TIA).
Main Results:
- Rest shunting and highly mobile fossa ovalis membranes (>6.5 mm) were more common in stroke patients with PFO.
- PFO patients with both rest patency and significant membrane mobility had a 12.5% risk of stroke/TIA recurrence at 24 months.
- The combination of rest patency and high membrane mobility identified a higher-risk subgroup for embolism.
Conclusions:
- Echocardiographic evaluation of PFO, specifically rest shunting and membrane mobility, is valuable for stroke recurrence risk stratification.
- Identifying patients with both rest patency and mobile PFO membranes can guide preventative strategies.
- These findings enhance understanding of PFO-related stroke mechanisms and risk assessment.