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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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An audit of persistent foramen ovale closure in 105 divers

Alex Pearman1, Luc Bugeja2, Martin Nelson2

  • 1Medical School, University of Bristol, Bristol, UK.

Diving and Hyperbaric Medicine
|July 14, 2015
PubMed
Abstract

Insights

Closure of a persistent foramen ovale (PFO) appears safe for divers, with most patients returning to unrestricted diving after the procedure. This audit provides valuable data on PFO closure for decompression illness (DCI) prevention.

Area of Science:

  • Cardiology
  • Diving Medicine
  • Interventional Cardiology

Background:

  • Right-to-left shunt across a persistent foramen ovale (PFO) is linked to decompression illness (DCI).
  • Percutaneous PFO closure is used to mitigate DCI risk.
  • Randomized controlled trial data for PFO closure in DCI prevention are lacking.

Purpose of the Study:

  • To audit the safety and efficacy of transcatheter PFO closure for reducing DCI risk in divers.
  • To provide audit data on PFO closure, as recognized by the UK's National Institute of Health and Clinical Excellence.

Main Methods:

  • Retrospective audit of transcatheter PFO closures performed by a cardiologist specializing in diving medicine.
  • Inclusion of 105 divers undergoing 107 procedures for DCI risk reduction.

Main Results:

  • Low rate of procedural complications, lower than a trial for stroke prevention.
  • Two patients developed atrial fibrillation requiring treatment.
  • One stroke occurred, deemed unrelated to PFO closure.
  • Two divers needed repeat procedures for residual shunt, but both returned to diving.
  • 81 out of 95 divers with follow-up data returned to unrestricted diving.

Conclusions:

  • PFO closure is a safe procedure for divers.
  • The majority of divers can return to unrestricted diving post-procedure.
  • Audit data support the efficacy of PFO closure in this cohort.
Keywords:
Patent foramen ovale (PFO)clinical auditechocardiographypersistent foramen ovaleright-to-left shunttranscatheter closure

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