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Current Cardiology Reviews


ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

Review Article

Percutaneous Patent Foramen Ovale Closure: Stroke and Beyond

Author(s): Sandeep Randhawa*, Jawahar L. Mehta and Gaurav Dhar

Volume 20, Issue 3, 2024

Published on: 11 March, 2024

Article ID: e110324227881 Pages: 10

DOI: 10.2174/011573403X276984240304044109

Price: $65


Over 750,000 individuals suffer from stroke annually in the United States, with 87% of these strokes being ischemic in nature. Roughly 40% of ischemic strokes occur in individuals 60 years of age or under. A quarter of all ischemic strokes have no identifiable cause despite extensive workup and are deemed cryptogenic in nature. Patent Foramen Ovales (PFO) has been postulated in stroke causation by either paradoxical embolization or platelet activation in the tunnel of the defect. The incidence of PFO is reported to be 15-25% in the general population but rises to 40% in patients with cryptogenic stroke. While the initial trials evaluating PFO closures were non-revealing, subsequent long-term follow-ups, as well as recent trials evaluating PFO closures in cryptogenic stroke patients 60 years of age or under, demonstrated the superiority of percutaneous closure compared to medical therapy alone, leading to FDA approval of PFO closure devices. In this review, we review the diagnosis of PFO, postulated stroke mechanisms, literature supporting PFO closure, patient selection for percutaneous closure, procedural considerations, and associated procedural complications.

Keywords: Patent foramen ovale, cryptogenic stroke, ischemic stroke, patent foramen ovale closure, paradoxical embolism, atrial septal defect, right-to-left shunt.

Graphical Abstract
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