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Patent Foramen Ovale Closure Versus Medical Therapy After Cryptogenic Stroke
We read with great interest the recent updated meta-analysis by Vaduganathan et  al evaluating patent foramen ovale closure for prevention of cryptogenic stroke.1 Although we congratulate and applaud their excellent work, we would like to comment on several important issues in the study.
Source: The American Journal of Medicine - May 19, 2018 Category: General Medicine Authors: Hong-Tao Tie, Rui Shi Tags: Letter Source Type: research

Patent Foramen Ovale and Risk of Perioperative Stroke
To the Editor Dr Ng and colleagues reported that having a patent foramen ovale (PFO) diagnosed preoperatively was associated with an increased risk of stroke occurring within 30 days after noncardiac surgery. The diagnosis of PFO was made only by transthoracic or transesophageal echocardiography without any evaluation of the magnitude of right-to-left shunting. Moreover, presence and severity of atrial septal aneurysm was not recorded as a risk factor. Large or permanent right-to-left shunting graded either by transcranial Doppler or transthoracic echocardiography bubble test has been associated with an increased risk of p...
Source: JAMA - June 26, 2018 Category: General Medicine Source Type: research

Patent Foramen Ovale and Risk of Perioperative Stroke —Reply
In Reply Dr Rigatelli and Mr Zuin suggest the need to further characterize PFO to identify subgroups of the population with PFO who are at increased risk of perioperative stroke and hence, targets for preoperative optimization.
Source: JAMA - June 26, 2018 Category: General Medicine Source Type: research

Device closure for patent foramen ovale in patients with cryptogenic stroke: a paradigm in evidence.
Authors: Ha FJ, Adams H, Palmer S PMID: 31523821 [PubMed - as supplied by publisher]
Source: Medical Journal of Australia - September 17, 2019 Category: General Medicine Tags: Med J Aust Source Type: research

Closure of patent foramen ovale for secondary prevention of cryptogenic stroke: current perspectives.
Authors: Makhija RR, Palaniswamy C, Aronow WS PMID: 32864016 [PubMed]
Source: Archives of Medical Science - September 1, 2020 Category: General Medicine Tags: Arch Med Sci Source Type: research

Management of Patients With a Patent Foramen Ovale With History of Stroke or TIA
This Clinical Guidelines Synopsis summarizes the American Academy of Neurology ’s practice advisory update on management of patients with a patent foramen ovale who have a history of stroke or transient ischemic attack.
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Preliminary Investigation of In situ Thrombus Within Patent Foramen Ovale in Patients With and Without Stroke
This study uses high-resolution optical coherence tomography to investigate whether patent foramen ovale could be the site of thrombus formation in patients with or without stroke.
Source: JAMA - May 25, 2021 Category: General Medicine Source Type: research

Transcranial Doppler Screening for Patent Foramen Ovale Closure in Cryptogenic Strokes in Young: A Single Center Experience from South India
CONCLUSIONS: R-L shunt is common in cryptogenic ischemic strokes in young. TCD with bubble contrast study is a noninvasive and feasible bedside tool to detect them. Applying the ESUS criteria in these cryptogenic strokes with a positive TCD bubble contrast study can be then used for selecting patients for more invasive tests like TEE. High-risk PFOs picked up with TEE can be then considered for PFO closure for secondary stroke prevention. The history of Valsalva maneuver-like activity (such as lifting heavy weights or straining) at the time of stroke onset can be a clinical predictor for the presence of an R-L shunt. In ad...
Source: Journal of the Association of Physicians of India - June 25, 2023 Category: General Medicine Authors: Deepti Bal Atif Iqbal Ahmed Shaikh Murali Rayani Sanjith Aaron Viji Samuel Thompson John Jose Jesu Krupa Rohit Ninan Benjamin Joanne Lydia Rajkumar Appaswamy Thirumal Prabhakar Source Type: research

Patent Foramen Ovale Closure —Harnessing Clinical Trial Evidence to Inform Individualized Treatment Decisions
According to some estimates, approximately one-quarter of the general US population has a patent foramen ovale (PFO). With such a high prevalence, clinicians frequently attempt to determine whether a PFO has had a causal role among patients who experience an unexplained stroke, and whether closing the PFO might reduce the risk of recurrent stroke. Several randomized clinical trials have compared the outcomes of PFO closure vs treatment with antiplatelet or anticoagulation agents. In 2016, the American Academy of Neurology conducted a systematic review of 3 trials and concluded that clinicians “should not routinely offer ...
Source: JAMA - December 14, 2021 Category: General Medicine Source Type: research

Treatment Effects in Analysis of Pooled Individual Patient Data From Randomized Trials of Device Closure of Patent Foramen Ovale
To the Editor In a recent study, Dr Kent and colleagues used previously developed scoring systems to estimate the risk of recurrent ischemic stroke in patients with patent foramen ovale (PFO) and concluded that the risk reduction for recurrent ischemic events with device closure varied across groups classified by their probabilities that the stroke was causally related to the PFO. Although these findings are interesting, they should be considered cautiously because other than right-to-left shunt and atrial septal aneurysm, no groups were stratified using anatomical and/or functional PFO variables. However, the magnitude of...
Source: JAMA - April 12, 2022 Category: General Medicine Source Type: research

Long-term Outcomes After Percutaneous Patent Foramen Ovale Closure.
In conclusion, the long-term rate of recurrent stroke after PFO closure is low in patients with a single neurological event at baseline. Serious long-term complications after PFO closure are rare. PFO closure may decrease the frequency and severity of migraine. PMID: 23328836 [PubMed - as supplied by publisher]
Source: The American Journal of the Medical Sciences - January 16, 2013 Category: Journals (General) Authors: Nagpal SV, Lerakis S, Flueckiger PB, Halista M, Willis P, Block PC, Douglas JS, Morris DC, Liff DA, Stewart J, Devireddy C, Veledar E, Nahab FB, Babaliaros VC Tags: Am J Med Sci Source Type: research

Persistent pathology of the patent foramen ovale: a review of the literature
Med J Aust. 2021 Jul 4. doi: 10.5694/mja2.51141. Online ahead of print.ABSTRACTA patent foramen ovale (PFO) is an interatrial shunt, with a prevalence of 20-34% in the general population. While most people do not have secondary manifestations of a PFO, some reported sequelae include ischaemic stroke, migraine, platypnoea-orthodeoxia syndrome and decompression illness. Furthermore, in some cases, PFO closure should be considered for patients before neurosurgery and for patients with concomitant carcinoid syndrome. Recent trials support PFO closure for ischaemic stroke patients with high risk PFOs and absence of other identi...
Source: Medical Journal of Australia - July 4, 2021 Category: General Medicine Authors: Kenneth K Cho Shaun Khanna Phillip Lo Daniel Cheng David Roy Source Type: research

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