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

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Patent foramen ovale.

Shunichi Homma1, Steven R Messé2, Tatjana Rundek3

  • 1Department of Medicine, Columbia University, College of Physicians and Surgeons, 630 West 168th Street, New York 10032, USA.

Nature Reviews. Disease Primers
|May 19, 2016
PubMed
Summary
This summary is machine-generated.

Patent foramen ovale (PFO), a common congenital heart defect, is linked to stroke risk. Current evidence suggests PFO closure offers no stroke reduction benefit over medical therapy.

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Area of Science:

  • Cardiology
  • Neurology
  • Congenital Heart Disease

Background:

  • Patent foramen ovale (PFO) is a common congenital heart abnormality affecting ~25% of adults.
  • It results from the failed closure of the fetal foramen ovale, allowing right-to-left atrial shunting.

Purpose of the Study:

  • To review the epidemiology, pathophysiology, diagnosis, screening, management, and quality of life effects of PFO.
  • To address the controversy surrounding PFO management in cryptogenic stroke patients.

Main Methods:

  • Review of existing literature and clinical trial data.
  • Discussion of diagnostic tools including echocardiography and transcranial Doppler.
  • Analysis of medical and interventional treatment strategies.

Main Results:

  • PFO is historically associated with stroke risk via paradoxical embolism, but evidence for increased risk in asymptomatic individuals is inconsistent.
  • Large trials show PFO closure does not reduce stroke risk compared to medical treatment.
  • Medical management with antiplatelet or anticoagulation therapy is recommended.

Conclusions:

  • Optimal treatment for cryptogenic stroke with PFO remains controversial.
  • Further research is needed to clarify the role of PFO in stroke etiology and management.
  • This primer provides a comprehensive overview for clinicians and researchers.