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Updated: Jul 28, 2025

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 closure in non-elderly and elderly patients with cryptogenic stroke: a hospital-based cohort

Po-Lin Chen1,2,3, Chi-Sheng Wang1, Jin-An Huang1,3,4

  • 1Division of Neurology, Taichung Veterans General Hospital, Neurological Institute, Taichung, Taiwan.

Frontiers in Neurology
|June 1, 2023
PubMed

Insights

Patent foramen ovale (PFO) closure reduced recurrent stroke and mortality in patients with cryptogenic stroke. Elderly patients undergoing PFO closure showed improved functional outcomes, suggesting its consideration in select older individuals.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • Patent foramen ovale (PFO) is a common cardiac anomaly.
  • The efficacy of PFO closure in elderly patients with cryptogenic stroke (CS) remains unclear.

Purpose of the Study:

  • To investigate the efficacy and safety of PFO closure in non-elderly and elderly patients with CS.
  • To compare outcomes between PFO closure and medical management alone.

Main Methods:

  • Prospective enrollment of patients (≥18 years) with CS/TIA and PFO.
  • Classification into PFO closure (PFOC) and medical treatment (non-PFOC) groups.
  • Primary outcome: composite of recurrent cerebral ischemic events and all-cause mortality; secondary outcome: modified Ranking Scale (mRS) at 180 days.

Main Results:

  • PFO closure significantly reduced the primary outcome in the total cohort (6.2% vs. 17.1%, HR=0.35, p=0.043).
  • Elderly patients with PFO closure showed a numerically lower risk of the primary outcome (HR=0.26, p=0.051) and better functional outcomes (lower median mRS, p=0.002).
  • Safety outcomes were similar between groups and age categories.

Conclusions:

  • PFO closure is associated with reduced risk of recurrent events in patients with PFO and CS.
  • Elderly patients with PFO closure experience better functional outcomes.
  • PFO closure may be a viable option for selected elderly patients with PFO.
Abstract

Keywords:
cryptogenic strokeischemic strokeoutcomepatent foramen ovalepatent foramen ovale closure

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