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Updated: Oct 12, 2025
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Transcatheter closure for decompression sickness with a patent foramen ovale: A case report
1Department of Ultrasound Medicine, Yanbian University Hospital, #1327 Juzi St. Yanji, 133000, Jilin, China.
Insights
Patent foramen ovale (PFO) closure effectively prevents recurrent decompression sickness. Device selection for PFO closure should consider atrial septum support, not just defect size.
Area of Science:
- Cardiology
- Vascular Surgery
- Diving Medicine
Background:
- Patent foramen ovale (PFO) is a recognized risk factor for neuro-decompression sickness (NDS).
- Transcatheter PFO closure offers a viable strategy for secondary NDS prevention in individuals with intracardiac shunts.
Observation:
- The selection of closure device size for PFO should be guided by the atrial septum's supportive capacity rather than solely by the PFO or atrial septal defect (ASD) dimensions.
- While the surgical techniques for PFO and ASD closure are similar, the specific closure devices differ.
Findings:
- The optimal closure device for PFO involves a larger right atrial component compared to the left atrial component.
- Appropriate device sizing and placement are crucial for effective atrial septum closure.
Implications:
- This approach may improve outcomes for divers and others at risk of decompression sickness.
- Further research into device-tissue interaction and long-term efficacy is warranted.
Abstract:
A patent foramen ovale is one of the predisposing factors of neurotic decompression sickness. Transcatheter closure of a patent foramen ovale is effective in the secondary prevention of decompression sickness associated with intracardiac shunt. The size of the umbrella should not be limited to the diagnosis of a patent foramen ovale or an atrial septal defect but should be determined by the supporting force of the soft margin of the atrial septum. The surgical method of patent foramen ovale closure is the same as that of the closure of an atrial septal defect, but the closure umbrella of a patent foramen ovale is different from that of the closure umbrella of an atrial septal defect. The size of the umbrella of the right atrium is larger than that of the left atrium, and it is better to close the atrial septum.
