Percutaneous Closure of Patent Foramen Ovale and Atrial Septal Defect in Athletes: A Study With a Long-Term Follow-Up

Patent foramen ovale (PFO) and atrial septal defect (ASD) percutaneous closure is routinely performed. However, data on long-term safety and efficacy in athletes are lacking. This study with a long-term follow-up investigated the safety and efficacy of percutaneous PFO/ASD closure in athletes compared to non-athletes, focusing on the impact of sports participation on complications. The study included individuals < 50 years old undergoing percutaneous PFO/ASD closure. Athletes practiced sports for ≥ 4 h/week for ≥ 2 consecutive years before and after the procedure. Periprocedural complications, device dislocation, and bleeding events were assessed during a long-term follow-up (mean 10.6 ± 5.1 years). Echocardiography, including transcranial Doppler bubble test, was performed before discharge, at 1 and 3 months, and yearly thereafter. Seventy-six patients (36 athletes and 40 non-athletes) were included. Fourteen patients practiced sports at risk of trauma, and no differences in periprocedural complications were observed between the two groups. During the follow-up, no device dislocation was observed in athletes. A single major bleeding occurred in a non-athlete during dual antiplatelet therapy (DAPT). Eight minor bleedings occurred (4 during DAPT, 4 during single antiplatelet therapy-SAPT), with no significant difference between athletes and non-athletes (p = 0.23 and p = 0.79, respectively). One minor sports-related bleeding (muscular hematoma) occurred during SAPT in an athlete practicing kickboxing. Percutaneous PFO/ASD closure is safe in athletes, with no differences in complication rates between athletes and non-athletes observed during long-term follow-up (> 10 years). Sports participation did not significantly increase the bleeding risk, even in athletes practicing sports at risk of trauma.