Contemporary Management of Patent Foramen Ovale

Meier, Bernhard; Lock, James E.

doi:10.1161/01.cir.0000046073.34261.c1

Cited by 225 publications

(172 citation statements)

References 48 publications

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“…Moreover, the coexistence of ASA identified a subgroup in which preventive strategies other than antiplatelet drugs such as oral anticoagulants, surgical or transcatheteral closure of PFO have to be considered [5]. However there are no clear-cut data on what solution is better in the management of patients with PFO plus ASA [6][7][8][9]. In the present work we have estimated the risk of recurrent ICVE (stroke or TIA) in patients with PFO or ASA treated with different therapies.…”

Section: Introductionmentioning

confidence: 99%

Recurrent cerebrovascular ischaemic events in patients with interatrial septal abnormalities: a follow-up study

et al. 2006

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The aim of this study was to evaluate the risk of recurrent ischaemic cerebrovascular events (stroke or transient ischaemic attack (TIA)) in patients with patent foramen ovale (PFO) or atrial septal aneurysm (ASA) treated with different therapeutic regimens. We enrolled 86 patients aged 18-60 years with an unexplained ischaemic stroke or TIA referred to our inpatient department in the period May 1994-December 1999. Follow-up lasted until April 2003. Patients were excluded if the stroke or TIA was related to large-artery atherosclerosis, small artery occlusion, major cardiac sources of embolism or other uncommon causes. During a follow-up (mean±SD) of 64.1±28.8 months (range 8.1-105.6) a recurrent ischaemic cerebrovascular event occurred in 11/86 patients (12.8%) (5 TIA and 6 strokes). Eight events (4 TIA, 4 strokes) occurred in the 59 patients with PFO alone, three (1 TIA, 2 strokes) in the 21 with PFO plus ASA and none in the 6 patients with ASA alone. In the overall population the cumulative risk of recurrent stroke/TIA was 1.2% at 2 years, 5.5% at 4 years, 7.6% at 6 years and 23.6% at 8 years, and was similar in patients with PFO alone vs. patients with PFO plus ASA (9.0% vs. 6.1% at 6 years, 26.0% vs. 23.1% at 8 years; p>0.05). Nine cerebral ischaemic events (4 TIA, 5 strokes) occurred in the 48 patients treated with antiplatelet drugs (7 in patients with PFO, 2 in patients with PFO plus ASA), and two (1 TIA, 1 stroke) in the 17 patients treated with oral anticoagulants (1 with PFO, 1 with PFO plus ASA). No events occurred in patients submitted to transcatheteral closure.

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Section: Introductionmentioning

confidence: 99%

Recurrent cerebrovascular ischaemic events in patients with interatrial septal abnormalities: a follow-up study

et al. 2006

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“…2 In spite of this, percutaneous PFO closure in patients with a paradoxical embolism has emerged as an alternative treatment strategy to lifelong anticoagulation, antiplatelet agents or surgical PFO closure. 3 Several peri-procedural and short-term complications have been recognized in PFO device implantation, but their rate is low. 4 Pericardial effusion after percutaneous PFO closure has been reported as a rare early complication.…”

Section: Discussionmentioning

confidence: 99%

Late cardiac tamponade after percutaneous closure of a patent foramen ovale

Christen

Mach

Didier

et al. 2005

European Journal of Echocardiography

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We report the case of a 35-year-old man who had a transient ischemic cerebral attack and then underwent a percutaneous closure of the patent foramen ovale (PFO) with a Cardiastar device. One year later, the patient developed a cardiac tamponade due to an important hemorrhagic pericardial effusion. Transoesophageal echocardiography showed that one of the struts had impinged on the aortic root in the region adjacent to the transverse pericardial sinus. Therefore, we speculated that the strut had passed through the aortic wall by slow erosion, leading to the pericardial effusion. Cardiac CT and subsequent surgery confirmed the perforation of the left atrial roof and the aortic root by two struts of the device. This is the first reported case of late cardiac tamponade and underscores the importance of long-term follow-up after PFO closure device implantation.

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“…(18) However, the latter holds true equally for strokes attributed to atrial fibrillation, prior myocardial infarction, or proximal arterial plaques.…”

Section: Pfo and Strokementioning

confidence: 99%