Fluoroscopy-only guided patent foramen ovale device closure: will it cut ice with the interventional community?
Publication date: Available online 31 March 2020Source: Canadian Journal of CardiologyAuthor(s): Anoop Mathew, Dylan Taylor (Source: Canadian Journal of Cardiology)
Source: Canadian Journal of Cardiology - March 31, 2020 Category: Cardiology Source Type: research

Clinical conundrum: concomitant high-risk pulmonary embolism and acute ischemic stroke
AbstractHigh-risk PE can be complicated by the presence of a patent foramen ovale (PFO), which can lead to paradoxical systemic embolization, including cerebral embolism ultimately leading to acute ischemic stroke (AIS). Acute management is challenging given the competing benefits and risks of systemic thrombolysis. Herein, we aim to provide a review of clinical presentations, diagnostic findings, and treatment and outcome from the available literature, with the hopes of providing insight into treatment options. We followed the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (P...
Source: Emergency Radiology - March 24, 2020 Category: Emergency Medicine Source Type: research

PFO! Should I Stay, or Should I Go?
IN THIS issue of the Journal of Cardiothoracic and Vascular Anesthesia, Villablanca et al. evaluated whether the presence and diagnosis of a patent foramen ovale (PFO) or atrial septal defect (ASD) preoperatively was associated with an increase in perioperative stroke for patients undergoing noncardiac surgery.1 The authors used “big data” to describe the largest study to date of 19,659,191 hospitalizations retrieved from the Healthcare Cost and Utilization Project's National Readmission Database. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 21, 2020 Category: Anesthesiology Authors: Yvonne Lai, Adam A. Dalia Tags: Editorial Source Type: research

Diagnosis of Patent Foramen Ovale: The Combination of Contrast Transcranial Doppler, Contrast Transthoracic Echocardiography, and Contrast Transesophageal Echocardiography.
Abstract Objectives: To access the distinct values of contrast transcranial Doppler (cTCD), contrast transthoracic echocardiography (cTTE), and contrast transesophageal echocardiography (cTEE) in the diagnosis of right-to-left shunt (RLS) due to patent foramen ovale (PFO) and to define the most practical strategy for the diagnosis of PFO. Methods: 102 patients with a high clinical suspicion for PFO had simultaneous cTCD, cTTE, and cTEE performed. The agitated saline mixed with blood was used to detect right-to-left shunt (RLS). Results: In all 102 patients, the shunt was detected at rest by cTCD in 60.78...
Source: Biomed Res - March 20, 2020 Category: Research Authors: Yang X, Wang H, Wei Y, Zhai N, Liu B, Li X Tags: Biomed Res Int Source Type: research

Expert Consensus Statement for the Management of Patients with Embolic Stroke of Undetermined Source and Patent Foramen Ovale: a clinical guide by the Working Group for Stroke of the Hellenic Society of Cardiology and the Hellenic Stroke Organization.
Authors: Ntaios G, Tzikas A, Vavouranakis E, Nikas D, Katsimagklis G, Koroboki E, Manolis AS, Milionis H, Papadopoulos K, Sideris S, Spengos K, Toutouzas K, Tziakas D, Vassilopoulou S, Kanakakis I, Vemmos K, Tsioufis K Abstract Patent foramen ovale (PFO) is a frequent echocardiographic finding and can be found in approximately 15-25% of the general population1 (Figure 1). The incidence of PFO is 2- to 3-fold higher in patients with stroke of undetermined etiology compared to the general population, a finding that implies a causative role of PFO in patients with stroke of undetermined etiology 2,3. In this context, ...
Source: Hellenic Journal of Cardiology - March 7, 2020 Category: Cardiology Tags: Hellenic J Cardiol Source Type: research

Persistent left superior vena cava in patient with right atrial myxoma undergoing open heart surgery. A case report and review of literature
Mostafa Elhamamsy, A Aldemerdash, F Zahran, BM Bakir, Nouf A Alanazi, Yasser Abdulrahman Awadallah, Sami Ibrahim Haggag, Mahmoud Salama AlshiekhSaudi Journal of Anaesthesia 2020 14(2):217-220 Persistent left superior vena cava (PLSVC) is a rare and asymptomatic congenital cardiovascular anomaly. Being asymptomatic, PLSVC was usually discovered while performing interventions (such as insertion of central lines, Swan-Ganz catheters, or placing pacemakers) through the left internal jugular vein or left subclavian veins. Commonly, PLSVC is detected not only as an isolated congenital anomaly, but also it can be associated with...
Source: Saudi Journal of Anaesthesia - March 5, 2020 Category: Anesthesiology Authors: Mostafa Elhamamsy A Aldemerdash F Zahran BM Bakir Nouf A Alanazi Yasser Abdulrahman Awadallah Sami Ibrahim Haggag Mahmoud Salama Alshiekh Source Type: research

Zero-fluoroscopy atrial fibrillation ablation in the presence of a patent foramen ovale: a multicentre experience
Conclusion The presence of a PFO may allow a completely fluoroless well tolerated and effective atrial fibrillation ablation. Probing the fossa ovalis looking for the PFO during the procedure is desirable, as it is not time-consuming and can potentially be done in every patient undergoing atrial fibrillation ablation. (Source: Journal of Cardiovascular Medicine)
Source: Journal of Cardiovascular Medicine - March 3, 2020 Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research

Updates in the Management of Cryptogenic Stroke and Patent Foramen Ovale
Conclusions: Stroke management is based on evaluation of individual patient-risk factors. Evaluation and treatment is ideally directed by a vascular neurologist to ensure optimal secondary prevention, especially in cases where an underlying etiology is not identified on initial workup. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - March 1, 2020 Category: Opthalmology Tags: Disease of the Year: Cerebrovascular Disorders Source Type: research

Increased Risk of Perioperative Ischemic Stroke in Patients Who Undergo Noncardiac Surgery with Preexisting Atrial Septal Defect or Patent Foramen Ovale
To evaluate whether a preoperative diagnosis of atrial septal defect (ASD) or patent foramen ovale (PFO) is associated with perioperative stroke in noncardiac surgery and their outcomes. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 29, 2020 Category: Anesthesiology Authors: Pedro A. Villablanca, Alejandro Lemor, Chak-Yu So, Guson Kang, Tarun Jain, Tanush Gupta, Tomo Ando, Divyanshu Mohananey, Sagar Ranka, Dagmar F. Hernandez-Suarez, Pablo Michel, Tiberio Frisoli, Dee Dee Wang, Marvin Eng, William O'Neill, Harish Ramakrishna Tags: Original Article Source Type: research

Updates in the Management of Cryptogenic Stroke and Patent Foramen Ovale
Conclusions: Stroke management is based on evaluation of individual patient-risk factors. Evaluation and treatment is ideally directed by a vascular neurologist to ensure optimal secondary prevention, especially in cases where an underlying etiology is not identified on initial workup. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - February 27, 2020 Category: Opthalmology Tags: Disease of the Year: Cerebrovascular Disorders Source Type: research

Left atrial appendage occlusion through a patent foramen ovale: should we or rather not?
Authors: Tzikas A, Papadopoulos K, Konstantinou D, Ntaios G, Arampatzis C PMID: 32092394 [PubMed - as supplied by publisher] (Source: Hellenic Journal of Cardiology)
Source: Hellenic Journal of Cardiology - February 26, 2020 Category: Cardiology Tags: Hellenic J Cardiol Source Type: research

Examining the evidence for PFO closure and novel oral anticoagulants for treatment of cryptogenic stroke.
Authors: Khan R Abstract Introduction: There has been considerable study assessing the treatment of cryptogenic stroke (CS) recently. This review examines the role of patent foramen ovale (PFO) closure in CS, while also discussing the evidence for alternative medical therapies in disease treatment.Areas Covered: PFO closure for treatment of CS has been assessed in 6 randomized controlled trials (RCTs). This review summarizes the background, results and limitations of these trials. Methodological and treatment-related differences in RCTs provide potential explanations for the discordance in outcomes observed between...
Source: Expert Review of Cardiovascular Therapy - February 24, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Clinical impact of transcatheter atrial septal defect closure on new onset atrial fibrillation in adult patients: Comparison with surgical closure.
Abstract BACKGROUND: Previous studies demonstrated that the incidence of atrial fibrillation (AF) was significantly increased when patients aged ≥40 years had surgical atrial septal defect (ASD) closure (sASD). However, limited information is available on such findings in transcatheter ASD closure (tASD). The purpose of this study was to investigate the incidence of newly developed AF after tASD in patients aged ≥40 years in whom preoperative AF or atrial flutter (AFL) had not been detected and to compare with the incidence after sASD. METHODS: The medical records of patients aged ≥40 years without a...
Source: Journal of Cardiology - February 22, 2020 Category: Cardiology Authors: Fujii Y, Akagi T, Nakagawa K, Takaya Y, Eto K, Kuroko Y, Kotani Y, Ejiri K, Ito H, Kasahara S Tags: J Cardiol Source Type: research

Impact of Patent Foramen Ovale on Total Knee Arthroplasty Cerebrovascular Accident Perioperative Management.
This study was undertaken to determine whether patients with a PFO would have a significantly increased risk of cerebrovascular accident (CVA) following TKA. The Humana national database was used to identify TKA patients who were stratified by the presence of a PFO from 2007 to 2016. Ninety-day follow-up was used for the primary outcome of CVA. Potential confounding comorbidities also were investigated, including age, sex, anticoagulation, insurance type, arrhythmia, valvular disease, peripheral vascular disease, chronic kidney disease, and diabetes mellitus. Of 153,245 TKAs, a total of 2272 patients had strokes; 479 of th...
Source: Orthopedics - February 20, 2020 Category: Orthopaedics Authors: Hong CS, Politzer C, Ryan SP, Wellman SS, Jiranek WA, Bolognesi MP, Seyler TM Tags: Orthopedics Source Type: research

Utility of Transthoracic Echocardiography in Diagnostic Evaluation of Ischemic Stroke
This study aims to investigate the utility of TTE as part of AIS workup.Methods: We collected data on consecutive patients with AIS who were admitted to our institution between 07/01/2016 and 09/30/2017. Patients were included based on neuroimaging-documented AIS, age>18 and neuroimaging studies. Primary endpoint was the proportion of cases in which TTE yielded relevant finding, defined as Atrial Septa Defect or Patent Foramen Ovale, left atrial enlargement, left ventricular thrombus or ejection fraction of
Source: Frontiers in Neurology - February 18, 2020 Category: Neurology Source Type: research

Congenital left ventricular outpouching and patent foramen ovale: a potentially emboligenic combination
Publication date: Available online 13 February 2020Source: Neurología (English Edition)Author(s): M. Lapeña-Reguero, R. Fábregas-Casal, M.D. Fernández-Couto, G. Barge-Caballero (Source: Neurologia)
Source: Neurologia - February 14, 2020 Category: Neurology Source Type: research

Transcatheter Patent Foramen Ovale Closure in a Child with Cryptogenic Ischemic Stroke
(Source: Indian Journal of Pediatrics)
Source: Indian Journal of Pediatrics - February 11, 2020 Category: Pediatrics Source Type: research

Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke
New England Journal of Medicine, Ahead of Print. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - February 10, 2020 Category: Internal Medicine Source Type: research

Comparison of Antiplatelet Therapies for Prevention of Patent Foramen Ovale-Associated Stroke
The REDUCE study demonstrated a reduction in the risk of recurrent stroke with patent foramen ovale closure and antiplatelet therapy compared to antiplatelet therapy alone. The clinicians were allowed to choose among aspirin, clopidogrel, or aspirin/dipyridamole with the expectation that all antiplatelet therapies would have similar efficacy in this population. We tested that presumption by comparing recurrent stroke rates among antiplatelet agents within the control arm of the trial. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - February 7, 2020 Category: Neurology Authors: Scott E. Kasner, Bryan Randall, Grethe Andersen, Helle K. Iversen, Risto Roine, Christina Sjostrand, John F. Rhodes, Lars S øndergaard, The Gore REDUCE Study Investigators Source Type: research

Patent foramen ovale, role of antiplatelet therapy alone or anticoagulant therapy alone versus device closure for cryptogenic stroke: A review of literature and current recommendations.
Authors: Nagarajarao HS, Ojha CP, Kedar A, Mukherjee D Abstract Cryptogenic stroke and its relation to the Patent foramen ovale (PFO) is a long debated topic. Recent clinical trials have unequivocally established the relationship between cryptogenic strokes and paradoxical embolism across the PFO. This slit like communication exists in everyone before birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communication between right and left atria in approximately 25-27% of adults [1, 2]. In this review we examine the clinical relevance of the PFO with analysis of latest trials eva...
Source: Cardiovascular and Hematological Agents in Medicinal Chemistry - February 6, 2020 Category: Cardiology Tags: Cardiovasc Hematol Agents Med Chem Source Type: research

Cardiovascular Imaging for Guiding Interventional Therapy in Structural Heart Diseases.
Authors: Rat N, Muntean I, Opincariu D, Gozar L, Togănel R, Chițu M Abstract Development of interventional methods has revolutionized the treatment of structural cardiac diseases. Given the complexity of structural interventions and the anatomical variability of various structural defects, novel imaging techniques have been implemented in the current clinical practice for guiding the interventional procedure and for selection of the device to be used. Three- dimensional echocardiography is the most used imaging method that has improved the threedimensional assessment of cardiac structures, and it has considerably...
Source: Current Medical Imaging Reviews - February 2, 2020 Category: Radiology Tags: Curr Med Imaging Rev Source Type: research

Patent Foramen Ovale “High-Risk” Anatomy
A 67-year-old man was admitted to the emergency department with a 2-day history of headache, nausea, and left-hand weakness. On physical examination, his blood pressure was 145/70 mm Hg, heart rate 80 beats per minute, respiratory rate 20 breaths per minute, oxygen saturation 92%, and the grip strength on his left hand was grade 3. His medical history included migraines and hypertension. Magnetic resonance imaging showed right parietal infarct on diffusion-weighted imaging. Laboratory test results revealed that complete blood count, partial thromboplastin time, and prothrombin time were normal. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 1, 2020 Category: Internal Medicine Authors: Julio C. Sauza-Sosa, Oscar Millan-Iturbe Tags: Medical image Source Type: research

Minimally Invasive Nonresectional Mitral Valve Repair Can Be Performed With Excellent Outcomes
Publication date: February 2020Source: The Annals of Thoracic Surgery, Volume 109, Issue 2Author(s): Andrea L. Axtell, Philicia Moonsamy, Jacob P. Dal-Bianco, Jonathan J. Passeri, Thoralf M. Sundt, Serguei MelnitchoukBackgroundTo review the efficacy of a minimally invasive surgical technique for mitral valve (MV) repair, we analyzed a nonresectional technique for degenerative mitral regurgitation.MethodsA retrospective analysis was performed on 101 consecutive patients who underwent a minimally invasive MV repair for severe degenerative mitral regurgitation between 2014 and 2017. All patients underwent a right lateral mini...
Source: The Annals of Thoracic Surgery - January 22, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Patent foramen ovale and stroke: current evidence and treatment options
Purpose of review Recent data have changed the landscape of patent foramen ovale (PFO) closure for secondary stroke prevention. This review synthesizes the data and provides a framework for optimal management of stroke patients with PFO. Recent findings The cumulative evidence indicates that PFO closure reduces the risk of recurrent stroke in carefully selected young cryptogenic stroke patients, with an annualized risk reduction of ∼0.6%. The benefit of PFO closure is particularly evident in patients with embolic appearing strokes, large right-to-left shunt, or an associated atrial septal aneurysm. There may be li...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research

Stroke after spontaneous intracranial hypotension: Not a single mechanism. Case report and review of literature
We report a case of SIH followed with brain infarction, with a distinct presentation from previous literature, suggesting a different mechanism. A 35 year-old had severe orthostatic headache, responsible for prolonged bed rest. One month later, he had acute left hemiparesis secondary to stroke and right posterior cerebral artery occlusion. Stroke MRI showed arguments for intracranial hypotension (thickened meninges). He was successfully treated with intravenous rtPA thrombolysis. Headache were resolved after an epidural blood patch. A patent foramen ovale was detected. Clinical features of this description were compar...
Source: Journal of Clinical Neuroscience - January 16, 2020 Category: Neuroscience Source Type: research

Periprocedural Outcomes of Fluoroscopy-Guided Patent Foramen Ovale Closure with Selective Use of Intracardiac Echocardiography
ConclusionOur single centre experience suggests that PFO closure can be safely conducted under fluoroscopic guidance alone with provisional adjunctive ICE use limited to specific anatomical situations. (Source: Canadian Journal of Cardiology)
Source: Canadian Journal of Cardiology - January 15, 2020 Category: Cardiology Source Type: research

Ischemic Stroke with Protein S Deficiency Treated by Apixaban
A 57-year-old man with atherosclerosis obliterans was admitted with sudden-onset sensory aphasia and right hemiparesis. Brain MRI revealed acute cerebral infarctions in the left temporal lobe and magnetic resonance angiography showed occlusion of the posterior branch of the left middle cerebral artery. Transesophageal echocardiography and ultrasonography respectively confirmed a patent foramen ovale and deep vein thrombosis in the bilateral femoral veins. Blood findings showed low protein S antigen, low protein S activity, and a missense mutation of the PROS 1 gene. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - January 13, 2020 Category: Neurology Authors: Ikkei Ohashi, Shinichi Wada, Fumitaka Yoshino, Takahiro Kuwashiro, Shinya Matsumoto, Taeko Hotta, Dongchong Kang, Yasushi Okada, Shun Shimohama, Masahiro Yasaka Tags: Case Report Source Type: research

Patent foramen ovale closure by using transesophageal echocardiography for cryptogenic stroke: single center experience in 132 consecutive patients
Percutaneous closure of patent foramen ovale (PFO) is routinely performed using plain fluoroscopy in the catheter room. This method results in inevitable radiation damage, adverse effects of contrast agents on... (Source: Journal of Cardiothoracic Surgery)
Source: Journal of Cardiothoracic Surgery - January 9, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Yangyang Han, Xiquan Zhang and Fengwei Zhang Tags: Research article Source Type: research

Percutaneous Patent Foramen Ovale closure: A Medico-Economic Study
ConclusionDecreasing the length of stay without compromising patients’ safety and defining the appropriate cost of ICE catheters with the industry and health authorities would permit to find safe and sustainable strategies for PFO closure. (Source: Archives of Cardiovascular Diseases Supplements)
Source: Archives of Cardiovascular Diseases Supplements - January 7, 2020 Category: Cardiology Source Type: research

Emergency thromboembolectomy for impending paradoxical embolism through a patent foramen ovale owing to venous thromboembolism in a severely obese patient
AbstractA severely obese patient with dyspnea and weighing 197  kg presented to us. He experienced an impending paradoxical embolism in the left ventricle caused by a deep vein thrombosis passing through a patent foramen ovale, as well as an acute massive pulmonary thromboembolism. Emergency thromboembolectomy from the right atrium and the bilateral pulmonary arteries was successfully performed. This is an extremely rare case of a severely obese patient with a body mass index of 66.6 kg/m2 who required emergency cardiac surgery by a cardiopulmonary bypass. (Source: General Thoracic and Cardiovascular Surgery)
Source: General Thoracic and Cardiovascular Surgery - January 2, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Response to the letter to the editor: & quot;Score risk scale as a prognostic factor after sudden sensorineural hearing loss & quot;
AbstractWe appreciate the opportunity to comment the observations on our paper entitled"Score risk scale as a prognostic factor after sudden sensorineural hearing loss", by Capuano et al. This letter highlights several important points, including the role of hyperbaric oxygen therapy and the possible association between patent foramen ovale and sudden sensorineural hearing loss (SSHL). Further research is needed to strengthen the association between cardiovascular risk and SSHL. We thank the authors for their insights into our paper and for adding their experience and observations on the potential role of cardiov...
Source: European Archives of Oto-Rhino-Laryngology - January 2, 2020 Category: ENT & OMF Source Type: research

Acute Limb Ischemia Secondary to Patent Foramen Ovale-Mediated Paradoxical Embolism: Case Report and Systematic Review of the Literature
Paradoxical embolism is the translocation of a thrombus originating in the systemic venous circulation into the arterial circulation through a cardiac defect, most commonly a patent foramen ovale (PFO). PFO exists in 15-35% of the adult population. The most common manifestation is cerebrovascular accident; acute limb ischemia is much rarer. (Source: Annals of Vascular Surgery)
Source: Annals of Vascular Surgery - January 2, 2020 Category: Surgery Authors: Jason W. Greenberg, Zackary D. Goff, Annie C. Mooser, Catherine M. Wittgen, Matthew R. Smeds Tags: Case Report Source Type: research

Light anti-thrombotic regimen for prevention of device thrombosis and/or thrombotic complications after interatrial shunts device-based closure.
CONCLUSIONS: A regimen of 100 mg of ASA for six months after ASD/PFO closure appeared to be both safe and effective in preventing device thrombosis and major bleedings. PMID: 31902564 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)
Source: European Journal of Internal Medicine - January 2, 2020 Category: Internal Medicine Authors: Rigatelli G, Zuin M, Dell'Avvocata F, Roncon L, Vassilev D, Nghia N Tags: Eur J Intern Med Source Type: research

Acute Limb Ischemia Secondary to Patent Foramen Ovale –Mediated Paradoxical Embolism: A Case Report and Systematic Review of the Literature
Paradoxical embolism is the translocation of a thrombus originating in the systemic venous circulation into the arterial circulation through a cardiac defect, most commonly a patent foramen ovale (PFO). PFO exists in 15 –35% of the adult population. The most common manifestation is cerebrovascular accident; acute limb ischemia is much rarer. (Source: Annals of Vascular Surgery)
Source: Annals of Vascular Surgery - January 2, 2020 Category: Surgery Authors: Jason W. Greenberg, Zackary D. Goff, Annie C. Mooser, Catherine M. Wittgen, Matthew R. Smeds Tags: Case Report Source Type: research

Gene-based anticoagulation regimens for an infant after mitral-valve replacement: A case report
Rationale: Heart-valve replacement is one of the main surgical methods for various heart-valve diseases. Warfarin is the only oral anticoagulant used for thrombosis prevention after heart-valve replacement. However, warfarin has a narrow therapeutic window, large differences in efficacy between individuals, and can be affected by drugs, food and disease status. Patient concerns: We used the Hamberg model to develop an anticoagulation regimen for a 10-month-old Chinese male after mitral-valve replacement. Diagnoses: Echocardiography revealed mitral malformation with severe regurgitation, patent foramen ovale, thicke...
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Long-term efficacy after closure of patent foramen ovale for ischemic neurological events in young adults: A systematic review and meta-analysis
Background: The efficacy of patent foramen ovale (PFO) closure remains controversial, and it is unclear which patient groups are best benefited. We performed this meta-analysis to clarify the efficacy of PFO closure of younger patients for prevention of recurrent ischemic neurological events. Methods: We systematically searched for studies of PFO closure for younger patients under the age of 55, and pooled available data on PFO closure of younger vs older patients and on PFO closure of younger patients vs medical therapy. The primary endpoints were the composite outcome of recurrent ischemic neurological events [strok...
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Incidental finding of a left atrial thrombus during surgical management of a massive pulmonary embolism.
Abstract A 58-year-old male presented with a hemodynamically significant pulmonary embolism. Computed tomography angiogram revealed a saddle embolus in the main pulmonary artery with extensive clot burden affecting all lobes and right heart strain. Transthoracic echocardiogram displayed a dilated right ventricle with reduced systolic function. The patient was scheduled for pulmonary embolectomy. The intraoperative transesophageal echocardiogram (TEE) demonstrated a mobile left atrial thrombus that was missed on previous imaging. After removal of the thrombi, TEE showed a patent foramen ovale (PFO). The left atrial...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Dunn S, Dave N, Rodriguez-Blanco YF, Aljure O Tags: Ann Card Anaesth Source Type: research

Thrombus in transit through a patent foramen ovale: An unusual cause of cardiac embolism
Publication date: Available online 13 December 2019Source: Journal of the Saudi Heart AssociationAuthor(s): Carlos Minguito-Carazo, Tomás Benito-González, Julio Cesar Echarte-Morales, Mario Castaño-Ruiz, Felipe Fernández-VázquezAbstractA 78-year-old woman with a history of transient ischemic attack was admitted for sudden aphasia. In order to assess the potential cardioembolic source an echocardiogram was performed, which revealed a large mass consistent with a thrombus in transit through a patent foramen ovale. Because of the high risk of systemic embolism, emergent surgical thrombectomy...
Source: Journal of the Saudi Heart Association - December 28, 2019 Category: Cardiology Source Type: research

Closure of patent foramen ovale in cryptogenic stroke: also in patients older than 60 years?
Publication date: Available online 25 December 2019Source: Revista Española de Cardiología (English Edition)Author(s): Jaime Masjuan, Sebastián García-Madrona, Alicia de Felipe (Source: Revista Espanola de Cardiologia)
Source: Revista Espanola de Cardiologia - December 25, 2019 Category: Cardiology Source Type: research

SCORE risk scale as a prognostic factor after sudden sensorineural hearing loss
AbstractMenezes et al. recently published an interesting study on cardiovascular prognostic factors for sudden sensorineural hearing loss (SSNHL), analyzing therapeutic strategies with intravenous and intratympanic corticosteroids and evaluating the application of the Systematic Coronary Risk Evaluation risk scale to classify risk in patients with SSNHL. In addition to intravenous and intratympanic corticosteroids, we would like to stress the role of hyperbaric oxygen therapy (HBOT). The new guidelines on SSNHL and the most recent scientific evidence emphasize the therapeutic role of HBOT. In a previous study, we recommend...
Source: European Archives of Oto-Rhino-Laryngology - December 23, 2019 Category: ENT & OMF Source Type: research

Importance of Abdominal Compression Valsalva Maneuver and Microbubble Grading in Contrast Transthoracic Echocardiography for Detecting Patent Foramen Ovale
Although transthoracic echocardiography (TTE) may be useful for patent foramen ovale (PFO) screening, the optimal methodologies remain unclear. The aims of this study were to evaluate the efficacy of the abdominal compression Valsalva maneuver and identify the optimal cutoff value of microbubbles in contrast TTE for detecting PFO, compared with transesophageal echocardiography and catheterization as the reference. (Source: Journal of the American Society of Echocardiography)
Source: Journal of the American Society of Echocardiography - December 16, 2019 Category: Cardiology Authors: Yoichi Takaya, Nobuhisa Watanabe, Madoka Ikeda, Teiji Akagi, Rie Nakayama, Koji Nakagawa, Norihisa Toh, Hiroshi Ito Source Type: research

Patent foramen ovale and the platypnea-orthodeoxia syndrome detected by transesophageal echocardiography
(Source: Journal of Echocardiography)
Source: Journal of Echocardiography - December 16, 2019 Category: Cardiology Source Type: research

Percutaneous Aortic Valve Closure in Patient With Left Ventricular Assist Device and Dilated Aortic Annulus
We report a successful percutaneous closure of the aortic valve using an oversized Amplatzer patent foramen ovale multifenestrated device (St Jude Medical, Saint Paul, MN) to treat aortic regurgitation associated with dilated aortic annulus in a patient with a continuous-flow left ventricular assist device. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - December 14, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Right heart tamponade and intermittent cyanosis due to Morgagni diaphragmatic hernia in a neonate
We describe a newborn with fetal aberrant ductus venosus with progressive right ventricular dilation prompting early delivery. Post-natally, the baby had frequent episodes of cyanosis. Echocardiogram during distress showed compression of the inferior vena cava and of the right heart, with significant right to left shunt through patent foramen ovale. Infant underwent successful laparoscopic diaphragmatic hernia repair with resolution in her episodes of cyanosis. (Source: Journal of Pediatric Surgery Case Reports)
Source: Journal of Pediatric Surgery Case Reports - December 14, 2019 Category: Surgery Source Type: research

Thrombus in transit through a patent foramen ovale, an unusual cause of cardiac embolism
Publication date: Available online 13 December 2019Source: Journal of the Saudi Heart AssociationAuthor(s): Carlos Minguito-Carazo, Tomás Benito-González, Julio Cesar Echarte-Morales, Mario Castaño-Ruiz, Felipe Fernández-VázquezAbstractA 78-year-old woman with history of transient ischemic attack was admitted for sudden aphasia. In order to assess a potential cardioembolic source an echocardiogram was performed revealing a large mass consistent with a thrombus in transit through a patent foramen ovale. Due to the high risk of systemic embolism emergent surgical thrombectomy was performed,...
Source: Journal of the Saudi Heart Association - December 13, 2019 Category: Cardiology Source Type: research

Reprint of : Transcatheter closure of patent foramen ovale to prevent stroke recurrence in patients with otherwise unexplained ischaemic stroke: Expert consensus of the French Neurovascular Society and the French Society of Cardiology.
CONCLUSIONS: Although a big step forward that will benefit many patients has been taken with recent trials, many questions remain unanswered. Pending results from further studies, decision-making regarding management of patients with PFO-associated ischaemic stroke should be based on a close coordination between neurologists/stroke specialists and cardiologists. PMID: 31787326 [PubMed - as supplied by publisher] (Source: Revue Neurologique)
Source: Revue Neurologique - December 5, 2019 Category: Neurology Tags: Rev Neurol (Paris) Source Type: research

Cryptogenic Stroke: Diagnostic Workup and Management
AbstractPurpose of reviewCryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural cardiac lesion, paroxysmal atrial fibrillation, hypercoagulable state or undiagnosed malignancy. Because many of these proposed mechanisms are embolic – and based on studies of thrombus history showing commonalities between thrombus composition between cardioembolic and cryptogenic strokes – the concept of embolic stroke of undetermined source (ESUS) (Hart et al....
Source: Current Treatment Options in Cardiovascular Medicine - December 3, 2019 Category: Cardiology Source Type: research

Stroke in the Young: a Global Update
AbstractPurpose of ReviewWe aim to evaluate the epidemiology, racial and gender disparity, etiology, and treatment of stroke in the younger population.Recent FindingsThe younger age group without vascular risk factors exhibits an increased prevalence of cardio-embolism in context of patent foramen ovale/atrial septal aneurysm strokes, from other determined etiology of non-atherosclerotic vasculopathy including dissection, inherited or acquired thrombophilia, and other unusual causes of stroke. Ethnic disparities also exist in certain populations.SummaryThe prevalence of stroke in the young is increasing due to several fact...
Source: Current Neurology and Neuroscience Reports - November 25, 2019 Category: Neuroscience Source Type: research

Patent foramen ovale in patients with atrial fibrillation
In this issue of the journal, Daher et al. [1] report that among 178 patients undergoing pulmonary vein isolation (PVI) procedures, a patent foramen ovale (PFO) was present in 57.3% of patients. This was determined because when a PFO was present, the catheter was advanced into the left atrium via the PFO, instead of performing a trans-septal perforation. A trans-esophageal echocardiogram (TEE) had detected a PFO in only 18.7% of the 75 patients who had a TEE prior to the PVI procedure. “The sensitivity and specificity of TEE in detection of PFO were 36.8% and 100%, respectively.” Although TEE is usually regarde...
Source: International Journal of Cardiology - November 22, 2019 Category: Cardiology Authors: Luciano Sposato, J. David Spence Tags: Editorial Source Type: research

Transcatheter Patent Foramen Ovale Closure Is Effective in Alleviating Migraine in a 5-Year Follow-Up
Conclusions: PFO closure is effective in alleviating migraine in the long term. This effect is more obvious when patients are younger than 45 years and RLS is large. (Source: Frontiers in Neurology)
Source: Frontiers in Neurology - November 19, 2019 Category: Neurology Source Type: research