Transcatheter Closure of Patent Foramen Ovale - A Single Center Experience

A patent foramen ovale (PFO) is present in 20%-30% of the adult population. It is usually found in patients incidentally, but clinical presentations could include stroke, seizures, and migraines. The aim of this study is to review the experience of PFO closure at our institution.

In this IRB approved clinical research study, we completed a retrospective chart review of 289 patients between the ages of 18-100 y old who came to our institute between January 2012 and December 2022. Our cohort had 173 female patients and 116 male patients. The patients' average age was 50.34 y. Our patient population identified as White (93.1%), Black (5.2%), and either Hispanic, Asian, or of mixed race (less than 2%).

The most common presenting symptoms for these patients included cerebrovascular accident, transient ischemic attack, migraine, venous thromboembolism, and dyspnea. The mean duration for follow-up was 3.2 y with a range of 1 wk-12 y. There were 10 immediate post-operative complications which included tachycardia (4), femoral vein bleed, rash due to an unknown reason, excessive fatigue, bradycardia, ascites, and severe headache. There were 18 deaths during the patient follow-up period due to co-morbidities or unrelated causes. Eighty-three patients reported to be asymptomatic at follow-up. When dividing patients between a younger and older group, both groups had similar rates of patients with no complications as well as post-operative complications of arrhythmias, cerebrovascular accidents, migraines, and syncope at follow-up.

The procedure-related deaths of PFO closure were low, but a significant number of patients died due to their co-morbidities and disease processes.