Device closure for patent foramen ovale in patients with cryptogenic stroke: which patients should get it?. (6th December 2020)

• Record Type: Journal Article
• Authors: Parrini, Iris; Cecchi, Enrico; Forno, Davide; Lyon, Alexander R; Asteggiano, Riccardo
• Is Part Of: European heart journal supplements. Volume 22(2020)Supplement M
• Page Start: M43
• Page End: M50
• Publication Date: 2020-12-06
• Subjects: Stroke -- Patent foramen ovale -- Cryptogenic stroke -- Embolic stroke -- Patent foramen ovale closure -- Secondary prevention; Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/suaa163
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: Patent foramen ovale (PFO) and cryptogenic stroke (CS) both have a high prevalence. The optimal treatment to reduce stroke recurrence after CS remains controversial. Results from clinical trials, meta-analyses, and position papers, support percutaneous PFO device closure and medical therapy compared to medical therapy alone. However, the procedure may be associated with cardiac complications including an increased incidence of new atrial fibrillation. The benefit/risk balance should be determined on a case-by-case basis with the greatest benefit of PFO closure in patients with atrial septal aneurysm and PFO with large shunts. Future studies should address unsolved questions such as the choice of medical therapy in patients not undergoing closure, the duration of antiplatelet therapy, and the role of PFO closure in patients over 60 years old.