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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

Broadening Our SCOPE of Understanding Patent Foramen Ovale High-risk Features and Stroke
Paradoxical embolization of a blood clot of presumed venous origin through a patent foramen ovale (PFO) is increasingly recognized as a legitimate cause of otherwise cryptogenic ischemic stroke (CIS). The term PFO-associated stroke has been proposed, as has where and how to classify this entity in the nomenclature of various ischemic stroke subtyping systems. PFOs are common, with prevalence as high as 25% in the general population. The prevalence of PFO is further increased in patients with CIS (overall 2.9 times higher), and especially so in the subset of younger patients (<55 years, 5.1 times higher). One estimate of...
Source: JAMA Neurology - October 10, 2022 Category: Neurology Source Type: research

Stroke in sickle cell disease and the promise of recent disease modifying agents
Sickle cell disease (SCD) is an inherited hemoglobinopathy affecting approximately 100,000 individuals in the United States. Cerebrovascular disease is among the most common and debilitating complications of SCA, with 53% experiencing silent cerebral infarct by age 30 and 3.8% experiencing overt stroke by age 40  years. This review highlights the burden of cerebrovascular disease in SCD, including both stroke and silent cerebral infarct (SCI). We then discuss the pathophysiology of stroke and cerebral fat embolism in the absence of a patent foramen ovale.
Source: Journal of the Neurological Sciences - September 8, 2022 Category: Neurology Authors: Ava Runge, Danielle Brazel, Zahra Pakbaz Tags: Review Article Source Type: research

Atrial Septal Defect and the Risk of Ischemic Stroke in the Perioperative Period of Noncardiac Surgery
Stroke is a serious complication of non-cardiac surgery. Congenital defects of the interatrial septum may be a potent risk factor for perioperative stroke. The aim of the present study was to determine the association between atrial septal defect (ASD) or patent foramen ovale (PFO) and in-hospital perioperative ischemic stroke after non-cardiac surgery in a large nationwide cohort of patients hospitalized in the United States. Patients undergoing noncardiac surgery between 2004 and 2014 were identified using the Healthcare Cost and Utilization Project's National Inpatient Sample.
Source: The American Journal of Cardiology - July 14, 2019 Category: Cardiology Authors: Nathaniel R. Smilowitz, Varun Subashchandran, Jeffrey S. Berger Source Type: research

Embolization of Endocardial Vegetation With Stroke Presentation
This case report details the unique cause of death of a 37-year-old Caucasian woman with a history significant for intravenous drug abuse. Before her death, she complained of extremity weakness and pain. Although her death was discovered to be the result of endocarditis, her symptoms were similar to that of a stroke. Autopsy revealed a large endocardial vegetation infecting both the tricuspid and mitral valves and a patent foramen ovale. The subsequent embolization of this vegetation caused blockages in the lungs, liver, and brain. An acute embolization of these vegetations to the bilateral middle cerebral arteries is the ...
Source: The American Journal of Forensic Medicine and Pathology - February 6, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Is Patent Foramen Ovale a Risk Factor for Perioperative Stroke?
Perioperative stroke is one of the most feared complications of any surgery or invasive medical procedure. Perioperative stroke occurs in less than 1% of patients undergoing general surgery, but the risk is several fold higher with cardiac surgery, carotid revascularization, other cerebrovascular procedures, and thoracic aortic repair. Given the volume of these interventions, perioperative and periprocedural stroke likely account for at least 5% of the approximately 800  000 strokes that occur each year in the United States, yet stroke in this setting remains understudied.
Source: JAMA - February 6, 2018 Category: General Medicine Source Type: research

Transcatheter closure of patent foramen ovale for secondary prevention of ischemic stroke: Quantitative synthesis of pooled randomized trial data
ConclusionsBased on the results of this analysis of randomized trial data, percutaneous PFO closure appears to be a safe and effective therapeutic option for the secondary prevention of ischemic stroke in patients with PFO and cryptogenic stroke.
Source: Catheterization and Cardiovascular Interventions - January 14, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Abdul Hakeem, Mehmet Cilingiroglu, Angelos Katramados, Konstantinos Dean Boudoulas, Cezar Iliescu, Betul Gundogdu, Konstantinos Marmagkiolis Tags: VALVULAR AND STRUCTURAL HEART DISEASES Source Type: research

Device used to close small hole in heart may protect against recurrent stroke
A device used to close a small hole in the heart may benefit certain stroke patients by providing an extra layer of protection for those facing years of ongoing stroke risk, according to the results of a large clinical trial led by UCLA researchers.“It is a major new treatment option for some people,” said Dr. Jeffrey Saver, director of theUCLA Comprehensive Stroke Center and lead author of the study. However, he added, “Using the device is going to have to be a considered clinical decision between the doctor and the patient about who’s the right person to get it.”Thefindings appear in the Sept. 14 New England Jo...
Source: UCLA Newsroom: Health Sciences - September 14, 2017 Category: Universities & Medical Training Source Type: news

Patent foramen ovale closure to prevent secondary neurologic events.
Abstract In October of 2016 the United States Food and Drug Administration approved the Amplatzer Patent Foramen Ovale (PFO) occluder device for use in patients with cryptogenic stroke, to reduce the risk of recurrent stroke. This event followed 15years of off-label use of atrial septal occluder devices, 3 randomized trials, and enormous controversy over the efficacy of this procedure. While none of the trials reached the primary endpoint needed to prove the efficacy of PFO closure in preventing recurrent stroke, meta-analyses and 5-year follow-up of 1 trial suggest that PFO closure decreases the risk of recurrent...
Source: European Journal of Internal Medicine - July 3, 2017 Category: Internal Medicine Authors: Jasper R, Blankenship JC Tags: Eur J Intern Med Source Type: research

Cryptogenic Stroke and Patent Foramen Ovale Risk Assessment
Publication date: Available online 29 June 2017 Source:Interventional Cardiology Clinics Author(s): Emiliya Melkumova, David E. ThalerTeaser Stroke is a devastating condition. It is the fifth leading cause of death in the United States, and a leading cause of serious long-term disability. Stroke occurs at any age. Younger patients tend to have strokes of undetermined cause, termed cryptogenic. Herein, the authors describe the classification of stroke cause; the risk of recurrent cryptogenic stroke with patent foramen ovale (PFO); a risk assessment model to stratify incidental versus a pathogenic PFO in patients presenting...
Source: Interventional Cardiology Clinics - June 30, 2017 Category: Cardiology Source Type: research