open access

Vol 79, No 3 (2021)
Review paper
Published online: 2021-02-17
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Long-term benefits and risks in patients after persistent foramen ovale closure: a contemporary approach to guide clinical decision making

Christian Pristipino, Fausta B. Filice
DOI: 10.33963/KP.15817
·
Pubmed: 33599457
·
Kardiol Pol 2021;79(3):248-254.

open access

Vol 79, No 3 (2021)
Review article
Published online: 2021-02-17

Abstract

Persistent foramen ovale (PFO) is a congenital heart disease which represents 80% of atrial septal defects. It is a remnant of fetal circulation that functions in postnatal conditions as a transient interatrial right‑to‑‑left shunt of variable magnitude. Persistent foramen ovale may be implicated in the pathogenesis of several medical conditions, such as cryptogenic stroke, cryptogenic left circulation thromboembolism, migraine syndromes, and decompression sickness. The most frequent indication for PFO closure remains PFO‑associated left circulation thromboembolism. In select patients, PFO closure reduces stroke recurrence in comparison with medical therapy after more than 3 years of follow‑up on average, especially in patients with a high risk of recurrence. While in PFO‑associated left circulation embolism, there is now conclusive evidence on the growing benefit of PFO closure in long‑term follow‑up, in many other clinical conditions, the degree of certainty of the results is deceiving. In this paper, we will review the benefits and risks that one can expect in the long term after percutaneous PFO closure in various clinical scenarios in order to facilitate therapeutic decision making.

Abstract

Persistent foramen ovale (PFO) is a congenital heart disease which represents 80% of atrial septal defects. It is a remnant of fetal circulation that functions in postnatal conditions as a transient interatrial right‑to‑‑left shunt of variable magnitude. Persistent foramen ovale may be implicated in the pathogenesis of several medical conditions, such as cryptogenic stroke, cryptogenic left circulation thromboembolism, migraine syndromes, and decompression sickness. The most frequent indication for PFO closure remains PFO‑associated left circulation thromboembolism. In select patients, PFO closure reduces stroke recurrence in comparison with medical therapy after more than 3 years of follow‑up on average, especially in patients with a high risk of recurrence. While in PFO‑associated left circulation embolism, there is now conclusive evidence on the growing benefit of PFO closure in long‑term follow‑up, in many other clinical conditions, the degree of certainty of the results is deceiving. In this paper, we will review the benefits and risks that one can expect in the long term after percutaneous PFO closure in various clinical scenarios in order to facilitate therapeutic decision making.

Get Citation
About this article
Title

Long-term benefits and risks in patients after persistent foramen ovale closure: a contemporary approach to guide clinical decision making

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 79, No 3 (2021)

Article type

Review paper

Pages

248-254

Published online

2021-02-17

DOI

10.33963/KP.15817

Pubmed

33599457

Bibliographic record

Kardiol Pol 2021;79(3):248-254.

Authors

Christian Pristipino
Fausta B. Filice

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