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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 unexplained ischemic cerebrovascular events in children

Mirjana Perkovic Benedik1, Marjan Zaletel, Nuska Pecaric Meglic

  • 1University Medical Center, Ljubljana, Slovenia.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 30, 2007
PubMed

Insights

The role of patent foramen ovale (PFO) in pediatric ischemic cerebrovascular events of unknown cause may be underestimated. Contrast transcranial Doppler with Valsalva maneuver is a sensitive method for PFO detection, and percutaneous PFO closure should be considered.

Area of Science:

  • Pediatric Neurology
  • Cardiology
  • Vascular Medicine

Background:

  • Limited data exist on paradoxical embolism in unexplained pediatric ischemic cerebrovascular events.
  • Patent foramen ovale (PFO) is a potential source of paradoxical embolism.

Purpose of the Study:

  • To evaluate the significance of PFO in children experiencing ischemic cerebrovascular events of unknown etiology.
  • To assess the utility of contrast transcranial Doppler (TCD) with Valsalva maneuver (VM) for PFO detection in this population.

Main Methods:

  • Retrospective study of pediatric patients with ischemic cerebrovascular events (2005-2007).
  • Contrast TCD with VM performed for unexplained events.
  • Percutaneous PFO closure offered for presumed paradoxical embolism.

Main Results:

  • Eighteen pediatric patients (median age 11.5 years) included; 12 with stroke, 6 with TIA.
  • PFO detected by TCD/VM in 4/6 stroke and 5/6 TIA patients with unexplained events.
  • Nine patients underwent attempted percutaneous PFO closure.

Conclusions:

  • PFO's role in unexplained pediatric ischemic cerebrovascular events may be underestimated.
  • Contrast TCD with VM is a sensitive, noninvasive tool for PFO detection in children.
  • Percutaneous PFO closure is a viable consideration for children with unexplained events and presumed paradoxical embolism.
Abstract

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