When to close a patent foramen ovale

Area of Science:

• Cardiology
• Pediatric Cardiology
• Interventional Cardiology

Background:

• Patent foramen ovale (PFO) closure is a frequent interventional procedure in adult congenital heart disease units.
• PFO prevalence is similar in pediatric populations.
• Children with PFO are susceptible to defect-related morbidity.

Purpose of the Study:

• To review the current practice of patent foramen ovale closure in pediatric patients.
• To evaluate the rationale for the disparity in PFO closure rates between adults and children.
• To question whether current guidelines on PFO closure in children should be reconsidered.

Main Methods:

• Literature review of studies on patent foramen ovale closure in adults and children.
• Analysis of data on PFO prevalence and associated morbidities in pediatric populations.
• Discussion of the benefits and risks of transcatheter PFO closure in pediatric patients.

Main Results:

• Transcatheter closure of PFO is the most common interventional procedure in adult congenital heart disease units.
• Despite similar prevalence, PFO closure is rarely performed in children.
• Children with PFO face similar risks of morbidity as adults.

Conclusions:

• There is a significant discrepancy in the application of transcatheter PFO closure between adult and pediatric populations.
• The similar susceptibility to morbidity suggests a potential underutilization of PFO closure in children.
• Further evaluation is warranted to determine if PFO closure should be more frequently considered in pediatric patients.