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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: the known and the to be known

Shelby Kutty1, Partho P Sengupta, Bijoy K Khandheria

  • 1Division of Pediatric Cardiology, University of Nebraska College of Medicine/Creighton University, Children's Hospital and Medical Center, Omaha, Nebraska, USA.

Journal of the American College of Cardiology
|May 5, 2012
PubMed

Insights

Patent foramen ovale (PFO) is a common heart defect. While implicated in cryptogenic stroke, its exact role and optimal PFO closure treatments require further research.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Patent foramen ovale (PFO) is a persistent opening between the atria, present in ~25% of adults.
  • PFO can serve as a pathway for clot travel from venous to arterial circulation, potentially causing stroke.
  • The direct link between PFO and cryptogenic stroke pathogenesis remains under investigation.

Purpose of the Study:

  • To review current knowledge on the clinical significance of PFO.
  • To discuss established and emerging treatments for PFO.
  • To identify knowledge gaps in PFO-related stroke and migraine pathophysiology.

Main Methods:

  • Review of existing literature on PFO.
  • Analysis of ongoing randomized trials comparing PFO closure and medical management.
  • Discussion of unresolved issues in PFO pathophysiology and patient selection for closure.

Main Results:

  • Compelling circumstantial evidence links PFO to cryptogenic stroke.
  • Ongoing trials are expected to clarify the efficacy of PFO closure versus medical management.
  • Further studies are needed to optimize patient selection and understand PFO's role in migraine.

Conclusions:

  • PFO closure trials are crucial for defining optimal treatment strategies.
  • More research is necessary to fully elucidate PFO's role in stroke and migraine.
  • Identifying patients who benefit most from PFO closure is a key future direction.

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