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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
10:52

Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence

Published on: December 23, 2022

Patent foramen ovale and stroke

Steven C Horton1, T Jared Bunch

  • 1Department of Cardiology, Department of Internal Medicine, LDS Hospital and University of Utah School of Medicine, Salt Lake City, USA. SCHorton@msn.com

Mayo Clinic Proceedings
|January 8, 2004
PubMed

Insights

Patent foramen ovale (PFO) closure significantly reduces embolic events. Medical treatments like aspirin or warfarin show limited benefit for stroke recurrence in PFO patients, especially with atrial septal aneurysm.

Area of Science:

  • Cardiology
  • Neurology
  • Embryology

Background:

  • Patent foramen ovale (PFO) is a common congenital heart defect with significant clinical implications.
  • PFO is linked to stroke, paradoxical embolism, and other serious conditions.
  • Mechanisms for stroke in PFO patients include paradoxical embolization and associated arrhythmias.

Purpose of the Study:

  • To review the clinical significance of PFO.
  • To evaluate treatment strategies for stroke prevention in PFO patients.
  • To assess the efficacy of PFO closure versus medical management.

Main Methods:

  • Review of prospective trials and existing literature on PFO.
  • Analysis of treatment outcomes for aspirin, warfarin, and PFO closure (surgical and catheter-based).
  • Assessment of successful closure criteria using transesophageal echocardiography.

Main Results:

  • Aspirin treatment did not prevent recurrent stroke in PFO patients with atrial septal aneurysm.
  • Warfarin did not offer additional benefit over antiplatelet therapy for stroke recurrence.
  • Both surgical and catheter-based PFO closure substantially decreased subsequent embolic events.

Conclusions:

  • PFO closure is effective in reducing embolic events.
  • Medical management alone is less effective for stroke prevention in specific PFO populations.
  • Further randomized trials are needed to compare anticoagulation with closure methods.

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