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Published on: February 28, 2012
Updates on Patent Foramen Ovale (PFO) Closure
Konstantinos V Voudris1, Marie-France Poulin2, Clifford J Kavinsky3
1Center for Valve and Structural Heart Disease, Minneapolis Heart Institute, Minneapolis, MN, USA.
Insights
Patent foramen ovale (PFO) closure is recommended for cryptogenic stroke, with new devices improving outcomes. Further research is needed for specific patient groups and conditions like migraines.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Patent foramen ovale (PFO) is associated with left circulation thromboembolism and stroke.
- Understanding PFO's role in various conditions is crucial for effective treatment.
Purpose of the Study:
- To review the latest evidence on PFO closure.
- To discuss updated guidelines, diagnostic tools, and novel devices for PFO closure.
Main Methods:
- Literature review of recent studies and societal guidelines.
- Analysis of diagnostic algorithms and risk stratification tools.
- Evaluation of emerging therapeutic devices for PFO closure.
Main Results:
- PFO closure is strongly recommended for cryptogenic stroke and systemic embolization.
- Evidence supports PFO closure for platypnea-orthodeoxia syndrome.
- Current data do not support routine PFO closure for migraines or decompression illness.
- Novel devices are under evaluation to enhance safety and efficacy.
- PFO closure shows superiority in reducing recurrent embolic stroke risk in select patients.
Conclusions:
- PFO closure is a valuable therapeutic option for specific thromboembolic conditions.
- Heart-brain teams and advanced algorithms can optimize patient selection.
- Continued research is necessary to refine patient selection and treatment strategies for subgroups.
Purpose Of Review:
Patent foramen ovale (PFO) has been previously linked to left circulation thromboembolism and stroke. This review article aims to discuss the latest evidence, updated societal guidelines, diagnostic algorithms and novel therapeutic devices for PFO closure.
Recent Findings:
PFO closure for cryptogenic stroke and systemic embolization is supported by a large body of evidence and has a strong societal recommendation. Limited data are available for platypnea-orthodeoxia syndrome, although closure appears to be beneficial. Current data do not support routine closure for migraines and decompression Illness. Development of heart-brain teams can improve identification of patients most likely to benefit from closure, utilizing a combination of imaging test and risk score algorithms. Multiple novel devices aiming at reducing complications and improving the long-term impact of current available devices are being evaluated. PFO closure has significantly progressed over the last years, with new data supporting its superiority in reducing risk of recurrent embolic stroke in patients with PFO-related stroke. Additional clinical data are required to provide further refinements on patient selection and guidance on treatment of specific subgroups.
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