Postoperative rescue closure of patent foramen ovale in the clinical setting of acute hypoxemic respiratory failure and stroke following coronary artery bypass surgery.

We describe a case of intraoperative diagnosis and successful deferred percutaneous closure of a patent foramen ovale (PFO) in the clinical setting of acute refractory hypoxemic respiratory failure and new-onset ischemic stroke in an elderly patient after coronary artery bypass graft. Perioperative morbidity (i.e. severe hypoxemia, worsening right ventricular dysfunction, and embolic stroke) that is potentially related to intraoperatively diagnosed PFO during cardiac surgery can complicate management in the Intensive Care Unit and perhaps affect the patient's outcome. Although the PFO closure can be challenging in the clinical setting of hypoxemic respiratory failure and stroke following cardiac surgery, it can be a reasonable perioperative option. PMID: 25566718 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research

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Authors: Madhkour R, Wahl A, Praz F, Meier B Abstract INTRODUCTION: The patent foramen ovale (PFO) is a common anatomical variant in humans (prevalence 25%). Most often asymptomatic, it may engender paradoxically embolic strokes, myocardial infarctions, or visceral or peripheral ischemia. It is causatively related to migraine, positional or exertional hypoxemia with dyspnea, diving incidents, high altitude edema, and sleep apnea. Percutaneous closure of atrial septal defects was first performed in the seventies. A dedicated PFO occluder (Amplatzer PFO Occluder) was first used on September 10, 1997 by Kurt Amplatz a...
Source: Expert Review of Medical Devices - Category: Medical Devices Tags: Expert Rev Med Devices Source Type: research
AbstractBackgroundWe aimed to explore whether interventional closure of patent foramen ovale (PFO) results in reduction of composite outcome [stroke/transitory ischemic attack (TIA), death, and thrombolysis in myocardial infarction —TIMI bleeding], stroke and stroke/TIA compared to medical treatment in patients with cryptogenic stroke.Methods and resultsSearching the PUBMED and Cochrane library database, we performed meta-analysis from all randomized controlled studies that compared effects of interventional PFO closure with medical treatment on stroke prevention. 3560 patients from six randomized trials were include...
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
ConclusionAmong admitted ischemic stroke patients, we did not find a higher prevalence of CIED in patients with PFO compared to controls. Therefore, in the underlying source population, the presence of CIED did not increase the PFO ‐associated ischemic stroke risk.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
Purpose of review The incidence of stroke in young adults is increasing, mainly driven by an increasing incidence of ischemic stroke in this population. We provide new information that has been recently presented regarding the risk factor prevalence, some specific etiologic causes, and management strategies in ischemic stroke in this population. Recent findings Recent studies indicate a rapid increase in traditional risk factors in young adults. New information regarding the management of patent foramen ovale in cryptogenic stroke and cervical artery dissection is available. Summary Stroke in young adults is a rapidly gr...
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: Stroke in young adults, Stroke prevention, All Cerebrovascular disease/Stroke, Carotid artery dissection Review Source Type: research
Contrast transcranial Doppler (cTCD) showed 100% sensitivity and specificity in the detection of right ‐to‐left shunt (RLS) compared to the current reference standard (i.e., transesophageal echocardiography—TEE) in consecutive patients aged
Source: Brain and Behavior - Category: Neurology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Tim Bastian Braemswig, Tatiana Usnich, Jan F. Scheitz, Hebun Erdur, Jochen B. Fiebach, Heinrich J. Audebert, Matthias Endres, Christian H. Nolte
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions: Our results suggest that inherited thrombophilias including FVL, PTM, PCD, and PSD are associated with an increased risk of arterial ischemic stroke, particularly in young patients. The association with FVL and PTM is stronger in the homozygous than in the heterozygous state, suggesting a potential dose-response relationship and causal role for inherited thrombophilias. The implications of these findings with respect to the evaluation and management of patients with ischemic stroke require further investigation.DisclosuresCrowther: Alnylam: Equity Ownership; Daiichi Sankyo: Membership on an entity's Board of D...
Source: Blood - Category: Hematology Authors: Tags: 331. Pathophysiology of Thrombosis: Poster II Source Type: research
ConclusionThe Occlutech device appears to be safe at long ‐term FU with a very low annual cerebrovascular event rate and a low moderate to large shunt rate at 1‐year FU.
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: VALVULAR AND STRUCTURAL HEART DISEASES Source Type: research
Authors: Hildick-Smith D, Turner M, Shaw L, Nakum M, Ó Hartaigh B, Evans RM, Rhodes JF, Sondergaard L, Kasner SE Abstract AIMS: Percutaneous closure of a patent foramen ovale (PFO) is known to lower the risk of recurrent stroke in patients with a cryptogenic stroke. However, the economic implications of transcatheter PFO closure are less well known. From a UK payer perspective, we performed a detailed economic appraisal of PFO closure for prevention of recurrent ischemic stroke in patients with a PFO who had experienced a cryptogenic stroke. MATERIALS AND METHODS: A Markov cohort model was constructed us...
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
Publication date: Available online 15 October 2018Source: Medical Journal Armed Forces IndiaAuthor(s): Vivek Aggarwal, A. Jayachandra, Naveen Aggarwal, Faiz AhmedAbstractBackgroundThe aim is to study cardiac abnormalities as detected by transesophageal echocardiography (TEE) in young patients (
Source: Medical Journal Armed Forces India - Category: General Medicine Source Type: research
More News: Anesthesia | Anesthesiology | Coronary Artery Bypass Graft | Intensive Care | Ischemic Stroke | Patent Foramen Ovale | Respiratory Medicine | Stroke