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Darwin and the patent foramen ovale phenotype
I read with great interest the recent review in the International Journal of Cardiology by Leong et al. on issues related to patent foramen ovale (PFO) occlusion. The article reviews the evidences of the link between PFO and cryptogenic stroke, migraine and decompression illness, supporting the concept that this association is based only on observational studies and, thus, it is impossible to draw any cause–effect relationship. Furthermore, no evidence recommends PFO closure in such patients since prospective studies available are questionable from the methodological point of view (e.g. confounding factors, statistics un...
Source: International Journal of Cardiology - January 16, 2014 Category: Cardiology Authors: Michele M. Ciulla Tags: Online Letters to the Editor Source Type: research

Prevalence of patent foramen ovale in atrial fibrillation patients with history of cerebral ischemia: A stand-alone additional risk?
Patent foramen ovale (PFO) is generally found in about 20–25% of the general population. The marked association between cryptogenic stroke/TIA and PFO supports the hypothesis that paradoxical embolism could be a major cause . The prevalence of foramen patency gradually decreases with age and probably also with conditions which can increase left atrial filling pressures .
Source: International Journal of Cardiology - January 21, 2014 Category: Cardiology Authors: Franco Zoppo, Giuseppe Stabile, Alessia Pappone, Andrea Avella, Domenico Pecora, Leonardo Corò, Gianluca Zingarini, Roberto Verlato, Antonello Castro, Emanuele Bertaglia Tags: Online Letters to the Editor Source Type: research

Patent foramen ovale, transient ischemic attack and Kounis syndrome
In their important meta-analysis of Ntaios et al.'s study published in this Journal , concerning all randomized control trials of patent foramen ovale closure versus medical treatment, the authors found no benefit in the prevention of cryptogenic shock and transient ischemic attack with implantation of unselected devices. However, in a subgroup analysis, selected closure devices may be superior to medical therapy without increasing the risk of new-onset atrial fibrillation. Indeed, in the CLOSURE trial the rate of stroke, transient ischemic attack, or death did not diminish and the risks of major vascular events and atrial...
Source: International Journal of Cardiology - January 23, 2014 Category: Cardiology Authors: George D. Soufras, Nicholas G. Kounis Tags: Online Letters to the Editor Source Type: research

Thrombus in transit: A link between pulmonary embolism and neurological embolic events
Patent foramen ovale (PFO) is a common finding on transesophageal echocardiogram and is increasingly blamed as a cause of paradoxical or cryptogenic stroke, particularly when right heart pressures are elevated . Therefore, in patients with prior or new pulmonary embolism (PE) presenting with a neurologic event, paradoxical embolism and PFO should be suspected and the PFO considered for closure . Although this association is known, the actual demonstration of a thrombus crossing a PFO (thrombus-in-transit) remains rare.
Source: International Journal of Cardiology - April 28, 2014 Category: Cardiology Authors: John Fani Srour, Joseph P. Mazza, Afshin Ehasn, David Donaldson, Daniel Levine Tags: Online Letters to the Editor Source Type: research

Association between acute myocardial infarction and death in 386 patients with a thrombus straddling a patent foramen ovale
Right atrial thrombi are rarely found straddling a patent foramen ovale (PFO). A thrombus straddling a PFO (TSPFO), also known as impending paradoxical embolism, is a medical emergency associated with up to 11.5% risk of death within 24  h of being diagnosed. We hypothesized that acute myocardial infarction (MI) and ischemic stroke (IS) diagnosed upon the admission of patients with TSPFO are associated with increased risk of death. We also investigated if specific acute therapies are associated with reduced in-hospital mortality.
Source: International Journal of Cardiology - July 7, 2021 Category: Cardiology Authors: Palak Shah, Amado Jimenez-Ruiz, Andrew Gibson, Juan C. Vargas-Gonz ález, Maria Bres-Bullrich, Rodrigo Bagur, Luciano A. Sposato Source Type: research

Real world long-term outcomes among adults undergoing transcatheter patent foramen closure with amplatzer PFO occluder
Patent foramen ovale (PFO) is a congenital heart defect associated with an increased risk of cryptogenic stroke. We aimed to evaluate real-world outcomes of adult patients undergoing transcatheter PFO closure with the Amplatzer PFO Occluder.
Source: International Journal of Cardiology - September 19, 2022 Category: Cardiology Authors: Lusine Abrahamyan, Madeleine Barker, Christoffer Dharma, Douglas S. Lee, Peter C. Austin, Areeba Asghar, Annamalar Muthuppalaniappan, Lee Benson, Mark Osten, Eric M. Horlick Source Type: research

Readmission in patients undergoing percutaneous patent foramen ovale closure in the United States
Current estimates suggest that a patent foramen ovale (PFO) may exist in up to 25% of the general population and is a potential risk factor for embolic, ischemic stroke. PFO closure complications include bleeding, need for procedure-related surgical intervention, pulmonary emboli, device malpositioning, new onset atrial arrhythmias, and transient atrioventricular block. Rates of PFO closure complications at a national level in the Unites States remain unknown. To address this, we performed a contemporary nationwide study using the 2016 and 2017 Nationwide Readmissions Database (NRD) to identify patterns of readmissions aft...
Source: International Journal of Cardiology - November 7, 2022 Category: Cardiology Authors: Chayakrit Krittanawong, Bing Yue, Muzamil Khawaja, Anirudh Kumar, Hafeez Ul Hassan Virk, Zhen Wang, Sana Hanif, Umair Khalid, Ali E. Denktas, Clifford J. Kavinsky, John J. Volpi, Hani Jneid Source Type: research

Patent foramen ovale closure with the Occlutech Figulla flex II device: A long-term (up to 10-years) follow-up
Percutaneous closure represents the first line of treatment In patients with cryptogenic stroke and documented patent foramen ovale (PFO). Scarce data report the long-term outcomes of patients undergoing PFO closure with the Figulla Flex II device (Occlutech, Germany).
Source: International Journal of Cardiology - June 8, 2023 Category: Cardiology Authors: Daniela Trabattoni, Sebastiano Gili, Giuseppe Calligaris, Giovanni Teruzzi, Sarah Troiano, Paolo Ravagnani, Giulia Santagostino Baldi, Piero Montorsi Source Type: research

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