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Review
. 2019 Feb;14(1):34-41.
doi: 10.15420/icr.2018.33.2.

Patent Foramen Ovale Closure in 2019

Joel P Giblett  1   2 , Omar Abdul-Samad  1 , Leonard M Shapiro  1 , Bushra S Rana  1 , Patrick A Calvert  1   2
Affiliations
Review

Patent Foramen Ovale Closure in 2019

Joel P Giblett et al. Interv Cardiol. 2019 Feb.

Abstract

Patent foramen ovale (PFO) is a common abnormality affecting between 20% and 34% of the adult population. For most people it is a benign finding; however, in some the PFO can open widely, enabling a paradoxical embolus to transit from the venous to arterial circulation, which is associated with stroke and systemic embolisation. Percutaneous closure of PFO in patients with cryptogenic stroke has been undertaken for a number of years, and a number of purpose-specific septal occluders have been marketed. Recent randomised controlled trials have demonstrated that closure of PFO in patients with cryptogenic stroke is associated with reduced rates of recurrent stroke. After a brief overview of the anatomy of a PFO, this review considers the evidence for PFO closure in cryptogenic stroke. The review also addresses other potential indications for closure, including systemic embolisation, decompression sickness, platypnoea-orthodeoxia syndrome and migraine with aura. It lays out the pre-procedural investigations and preparation for the procedure. Finally, it gives an overview of the procedure itself, including discussion of closure devices.

Keywords: Patent foramen ovale; cryptogenic stroke; decompression sickness; paradoxical embolus; percutaneous closure; platypnoea-orthodeoxia syndrome; septal occluders; systemic embolisation.

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Conflict of interest statement

Disclosure: PC undertakes proctoring for Abbott and Occlutech. The other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Echocardiographic Assessment of a Patent Foramen Ovale
Figure 2:
Figure 2:. Percutaneous closure of a Patent Foramen Ovale
Figure 3:
Figure 3:. Patent Foramen Ovale Closure Devices
See this image and copyright information in PMC

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