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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
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Patent Foramen Ovale and Decompression Illness: The Present and Future
Sanjana Nagraj1, Leonidas Palaiodimos2
1Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, USA.
Cardiology Clinics
|September 25, 2024
Summary
Patent foramen ovale (PFO) increases decompression illness (DCI) risk. Testing for PFO is advised after unexplained DCI, with closure considered for divers unable to stop or modify their activity.
Area of Science:
- Cardiology
- Diving Medicine
- Neurology
Background:
- Patent foramen ovale (PFO) is a common cardiac anomaly.
- High-grade PFO is linked to an increased risk of decompression illness (DCI).
- DCI can manifest in severe neurologic, cutaneous, or cardiopulmonary forms.
Purpose of the Study:
- To outline diagnostic indications for PFO in patients with DCI.
- To recommend management strategies for divers with PFO and DCI history.
- To highlight the need for further research on PFO closure outcomes in divers.
Main Methods:
- Bubble contrast echocardiography for PFO detection.
- Transcranial Doppler with provocative maneuvers for PFO diagnosis.
- Cardiology evaluation by diving medicine specialists.
Main Results:
- PFO testing is indicated in unprovoked or recurrent DCI.
- Cardiology consultation is recommended for PFO patients with DCI history.
- PFO closure is a consideration for divers unable to cease or modify diving activities.
Conclusions:
- PFO is a significant risk factor for severe DCI.
- Diagnostic protocols should include PFO screening in specific DCI cases.
- Further prospective studies are essential to assess long-term outcomes of PFO closure in active divers.
