Current status of percutaneous PFO closure

Area of Science:

• Cardiology
• Neurology
• Pulmonology

Background:

• The clinical significance of persistent patent foramen ovale (PFO) remains ill-defined, despite associations with various conditions.
• Transcatheter PFO closure has been available for over two decades but remains controversial due to limited evidence for patient and device selection.

Purpose of the Study:

• To review the potential clinical significance of PFO in adults.
• To appraise recent evidence on PFO closure for cryptogenic stroke, migraine, and orthodeoxia/platypnea.
• To discuss the safety, efficacy, patient selection, and future of transcatheter PFO treatment.

Main Methods:

• Review of contemporary studies and longitudinal data on transcatheter PFO closure.
• Appraisal of evidence for PFO closure in specific clinical conditions.
• Discussion of safety, benefit, patient selection, and future directions.

Main Results:

• Recent studies provide new evidence on the safety and efficacy of transcatheter PFO closure.
• Longitudinal data is now available for evaluating device performance.
• Plausible biologic mechanisms support PFO closure as a treatment for specific conditions.

Conclusions:

• Transcatheter PFO closure is a potential treatment for select patients with cryptogenic stroke, migraine, and orthodeoxia/platypnea.
• Emerging evidence supports the safety and efficacy of PFO closure, guiding future patient and device selection.
• Further research and data are crucial for optimizing transcatheter PFO treatment strategies.