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

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Published on: December 23, 2022

Decrease in shunt volume in patients with cryptogenic stroke and patent foramen ovale.

Christian Tanislav¹, Manfred Kaps, Marek Jauss

¹Department of Neurology, Justus Liebig University, Giessen, Germany. Christian.Tanislav@neuro.med.uni-giessen.de

|December 31, 2010

Summary

This summary is machine-generated.

Right-to-left shunt (RLS) volume across a patent foramen ovale (PFO) decreases over time, particularly in cryptogenic stroke patients. This finding may inform new secondary stroke prevention strategies.

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Area of Science:

Cardiology
Neurology
Vascular Medicine

Background:

Patent foramen ovale (PFO) is associated with stroke.
Evidence suggests right-to-left shunt (RLS) volume may change over time in PFO patients.
Understanding RLS changes is crucial for managing PFO patients with stroke history.

Purpose of the Study:

To investigate the hypothesis of RLS volume changes over time in patients with PFO and a history of stroke.
To assess the association between stroke type and RLS volume changes.
To determine factors influencing RLS volume reduction in PFO patients.

Main Methods:

A cohort of 102 patients with stroke and PFO underwent repeat RLS volume assessment using contrast-enhanced transcranial Doppler/duplex (ce-TCD) ultrasound.
RLS volume was compared between the index stroke event (T0) and a follow-up visit (T1), with a median interval of 10 months.
A change in RLS volume was defined as ≥20 microembolic signals (MES) difference or no detectable RLS at follow-up.

Main Results:

A significant reduction in RLS volume was observed in 31 out of 102 patients.
In 14 of these patients, the PFO was no longer detectable on follow-up.
Cryptogenic stroke as the index event (P < 0.001) and the time to follow-up (P = 0.03) were independently associated with RLS volume change.

Conclusions:

RLS volume across a PFO tends to decrease over time.
This reduction is more pronounced in patients experiencing cryptogenic stroke.
Findings may guide the development of novel secondary stroke prevention strategies for PFO patients.