[Patent foramen ovale and stroke]

"Patent foramen ovale and stroke Patent foramen ovale (PFO) is a remnant of the fetal circulation whose role in the occurrence of ischemic stroke is now well established. Trancatheter PFO closure followed by long-term antiplatelet therapy reduces by approximately 60% compared to antithrombotic therapy alone, the risk of stroke recurrence in patients aged 60 years or less with an ischemic stroke attributed to a PFO. Patients with PFO associated with an atrial septal aneurysm or with a large right-to-left shunt might be the best candidates. The superiority of oral anticoagulants over aspirin is uncertain. Their benefit compared to PFO closure is unknown. Other studies are needed to: (i) precisely define the patients who benefit the most, little or not at all from PFO closure, (ii) assess the long-term prognosis of atrial fibrillation induced by PFO closure, (iii) evaluate the benefit of the closure in patients not included in the therapeutic trials, in particular patients over the age of 60, (iv) evaluate the role of oral anticoagulants compared to aspirin and to PFO closure."