Long-Term Outcome After Percutaneous Closure of Patent Foramen Ovale for Cryptogenic Ischemic Events

Area of Science:

• Cardiology
• Neurology
• Interventional Cardiology

Background:

• Randomized trials indicate percutaneous closure of patent foramen ovale (PFO) reduces recurrent ischemic events compared to medical therapy.
• Long-term follow-up is crucial to validate the sustained impact of PFO closure on preventing future ischemic events.

Purpose of the Study:

• To perform a long-term follow-up analysis validating the impact of PFO closure on recurrent ischemic events.
• To compare event rates between different occluder devices and patient subgroups.

Main Methods:

• A total of 570 patients were enrolled and followed for recurrent ischemic events for a median of 7.2 years.
• PFO closure was performed using either the Amplatzer occluder or other devices (BioStar, Cardia, Premere).
• Analysis included comparisons of recurrent stroke, transient ischemic attack, and all-cause mortality rates based on device type, presence of atrial septal aneurysm, shunt grade, and patient age.

Main Results:

• Within 10 years, recurrent ischemic stroke occurred in 5.1% of patients receiving the Amplatzer occluder versus 7.6% with other occluders (P=.61).
• No significant differences were observed in recurrent transient ischemic attack or all-cause mortality rates between device groups.
• Patients younger than 45 years at the time of occluder implantation showed a trend towards lower recurrent stroke rates (P=.05).

Conclusions:

• Long-term follow-up after PFO closure demonstrates a low rate of recurrent stroke.
• No significant differences in event rates were found between different occluder devices, atrial septal aneurysm presence, or shunt grade.
• Younger patients (<45 years) experienced significantly lower rates of recurrent ischemic stroke.