The interest of surgical closure of patent foramen ovale after stroke: A preliminary open study of 8 cases

Giroud, M.; Tatou, Etienne; Steinmetz, Éric; Lemesle, M.; Cottin, Yves; Je, Wolf; Moreau, Thibault; David, Michel

doi:10.1080/01616412.1998.11740521

Cited by 6 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 6 We await the long‐term outcomes of ASD closure with per‐catheter occluder devices in a similar group of patients. However, evidence for a decrease in neurological events following surgical closure of PFO and small ASD is largely anecdotal 7 or lacking. 8 At a time when the long‐term outcome of per‐catheter closure devices is unclear and there are reports of the development of left atrial thrombus associated with some device designs, it seems premature to advise that this technique be used in the closure of PFO and non‐haemodynamically significant ASD.…”

Section: Discussionmentioning

confidence: 99%

Thrombus on an ASD closure device: A call for caution

Cooke

Gelman

Menahem

et al. 2000

Heart, Lung and Circulation

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Thrombus on an ASD closure device: A call for caution

Cooke

Gelman

Menahem

et al. 2000

Heart, Lung and Circulation

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

“…We reviewed ten uncontrolled case series, each including 7-91 patients with ischaemic strokes, who had been followed after surgical repair of their PFO [49,[51][52][53][54][55][56][57][58][59]. Of these, only two have reported the average time intervals between the index event and the surgical closure of the PFO.…”

Section: Risk Of Ischaemic Stroke After Closure Of Pfomentioning

confidence: 99%

“…In some series, the hazards of recurrent events during the first year after surgery were 3% [58], 8% [56] and 10% [53], and declined two [57] and four [56] years after surgery. However, other authors [49,[51][52][53][54][55][56][57] have reported a total of 90 patients who had no recurrent events during the first year after surgery. Table 2 summarizes 12 uncontrolled case series of more than 100 patients, who had been followed for two or more years after transcatheter closure of PFO [43,48,[60][61][62][63][64][65][66][67][68][69].…”

Section: Risk Of Ischaemic Stroke After Closure Of Pfomentioning

confidence: 99%

See 1 more Smart Citation

Variability in duration of follow up may bias the conclusions of cohort studies of patients with patent foramen ovale

Baumal

2008

Euro J of Neurology

View full text Add to dashboard Cite

Closure of patent foramen ovale (PFO) is expected to prevent paradoxical emboli. In the absence of randomized trials, its efficacy has been assessed by comparing uncontrolled cohort studies of medically treated patients with those treated by PFO closure. The objective of this study was to highlight a confounder of such studies, namely, the variability in the duration of follow-up. We searched the literature for cohort studies of patients with ischaemic strokes, including those with PFO. During the first year of follow-up, recurrence hazards in patients younger than 55 years were 1-4% in those with any ischaemic stroke, 1-6% in medically treated patients with PFO and 0-5% in those after PFO closure. In most studies, the recurrence hazards were highest immediately after the index stroke and declined thereafter. Still, hazards were commonly reported in terms of annual averages over a wide range of follow-up periods for the various cohort studies, thereby ignoring the possibility that the duration of the follow-up may in and of itself affect the derived average recurrence hazards. A disregard of the time variance of stroke recurrence may confound the conclusions from comparisons between uncontrolled studies of patients with stroke and PFO.

show abstract

“…Two independent case‐control studies reported an unusual high incidence of PFO (50% and 54%) in young cryptogenic stroke patients 7,8 . The prevention of strokes and recurrent strokes in patients with combined PFO and ASA remains still a therapeutic problem 9–11 . Treatment options range from no therapy to antiplatelet and/or anticoagulant therapy, or transcatheter closure to surgical closure.…”

mentioning

confidence: 99%

Surgical Closure of Combined Symptomatic Patent Foramen Ovale and Atrial Septum Aneurysm for Prevention of Recurrent Cerebral Emboli

Klotz¹,

Tjan²,

Berendes

et al. 2005

Journal of Cardiac Surgery

View full text Add to dashboard Cite

Background: Patients with patent foramen ovale (PFO) have an undefined but certainly considerable risk of repeated cerebral ischemia due to paradoxical embolism. Especially, if a cerebrovascular event has already occurred and the combination with an atrial septum aneurysm (ASA) is present this risk increases tremendously. The aim of this study was to demonstrate that surgical closure of PFO in combination with an ASA is safe and useful in preventing recurrent strokes. Methods: Ten patients with previous cerebral ischemia, proven by CT or MRI, and PFO in combination with an ASA were prospectively scheduled for surgical closure. Patients with extracardiac sources of embolic disease were excluded from this study. However, one patient suffered from a hypercoagulability syndrome. Results: All patients (mean age 35.5 ± 19.1 years) underwent direct suture of the PFO and plication of the ASA with the aid of cardiopulmonary bypass and cardioplegic arrest (n = 3) or ventricular fibrillation (n = 7). Mean operation time was 123.1 ± 20.2 minutes; mean bypass time was 34.5 ± 9.9 minutes. There was no mortality or significant postoperative morbidity. Mean hospital stay was 5.1 ± 1.5 days. During a follow-up of >4 years, no recurrent stroke or transient ischemic attack occurred and no patient received anticoagulation therapy. Conclusion: Our data suggest that surgical closure of PFO in combination with ASA in patients with previous stroke is safe and efficacious to prevent recurrent strokes and avoids lifelong anticoagulation.

show abstract

The interest of surgical closure of patent foramen ovale after stroke: A preliminary open study of 8 cases

Cited by 6 publications

References 23 publications

Thrombus on an ASD closure device: A call for caution

Thrombus on an ASD closure device: A call for caution

Variability in duration of follow up may bias the conclusions of cohort studies of patients with patent foramen ovale

Surgical Closure of Combined Symptomatic Patent Foramen Ovale and Atrial Septum Aneurysm for Prevention of Recurrent Cerebral Emboli

Contact Info

Product

Resources

About