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Cerebral Air Embolism Following Central Venous Catheter Removal
Air embolism is a rare but potentially fatal complication of central venous catheterization1. Venous air emboli can paradoxically enter the arterial circulation through a patent foramen ovale. Paradoxical shunting of air emboli through a patent foramen ovale can lead to cerebral air embolism and cause neurological compromise2. An atrial septal aneurysm is redundant atrial tissue that protrudes towards either or both atria during the cardiac cycle. It significantly increases the risk of embolic stroke when associated with a patent foramen ovale3.
Source: The American Journal of Medicine - August 10, 2017 Category: General Medicine Authors: Liane A. Arcinas, Shuangbo Liu, G. Isanne Schacter, Malek Kass Tags: Clinical Communication to the Editor Source Type: research

A cautionary perspective on the utility of the RoPE score in cryptogenic stroke patients with a patent foramen ovale.
Authors: Boon KJ, Bridgman P PMID: 28694541 [PubMed - in process]
Source: New Zealand Medical Journal - July 13, 2017 Category: General Medicine Tags: N Z Med J Source Type: research

Reducing Recurrent Strokes
Adevice that reduces the risk of a second stroke in patients whose first may have resulted from a blood clot traveling through a patent foramen ovale (PFO) and on to the brain has received FDA approval.
Source: JAMA - January 3, 2017 Category: Journals (General) Source Type: research

Decompressive craniectomy for malignant middle cerebral artery infarction in a 16-year old boy: a case report
ConclusionsThis case highlights the preponderance of cryptogenic stroke in younger patients and its etiological elusiveness. It further demonstrates that age is predictive in terms of survival and functional outcome in the context of malignant middle cerebral artery infarction.
Source: Journal of Medical Case Reports - December 19, 2016 Category: Journals (General) Source Type: research

Sudden onset hemiplegia at high altitude
This report describes a case of posterior circulation infarct thought to be due to a paradoxical embolus through a patent foramen ovale. The relationship between high-altitude physiology, increased incidence of thromboembolism and the significance of patent foramen are discussed in the report.
Source: Journal of the Royal Army Medical Corps - November 27, 2016 Category: Journals (General) Authors: Chandler, H. C., Mellor, A. Tags: Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Stroke, Venous thromboembolism Case report Source Type: research

Cryptogenic Strokes and Patent Foramen Ovales: What's the Right Treatment?
More than 25% of all ischemic strokes per year are cryptogenic, that is, their cause is not determined after an appropriate evaluation. In 1988, it was reported that the incidence of a patent foramen ovale was 30 to 40% in young patients with a cryptogenic stroke compared with 25% in the general population. This led to the suspicion that cryptogenic strokes were due to paradoxical embolism, that is, a venous thrombus crossing a patent foramen ovale to enter the left atrium and then the arterial circulation.
Source: The American Journal of Medicine - August 22, 2016 Category: Journals (General) Authors: James E. Dalen, Joseph S. Alpert Tags: Review Source Type: research

Cryptogenic Strokes and Patent Foramen Ovales: What ’s The Right Treatment?
More than 25% of all ischemic strokes per year are cryptogenic; that is their cause is not determined after an appropriate evaluation.In 1988 it was reported that the incidence of a patent foramen ovale (PFO) was 30 to 40% in young patients with a cryptogenic stroke compared to 25% in the general population. This led to the suspicion that cryptogenic strokes were due to paradoxical embolism; that is a venous thrombus crossing a patent foramen ovale to enter the left atrium and then the arterial circulation.
Source: The American Journal of Medicine - August 22, 2016 Category: Journals (General) Authors: James E. Dalen, Joseph S. Alpert Tags: Review Source Type: research

A very rare association between giant right atrial myxoma and patent foramen ovale. Extracellular matrix and morphological aspects: a case report.
We report a case of sporadic giant cardiac myxoma with a rare localization in the right atrium, operated in our Service, in a 73-year-old female patient who also presented a patent foramen ovale and a history of ischemic stroke in the year prior to current admission. Intra-operatively, the tumor had a very friable, gelatinous aspect, with a high potential for embolization due to its reduced consistency. The present paper refers to clinical, histochemical and immunohistochemical particularities, as well as to macroscopic and microscopic characteristics of the cardiac myxoma, emphasizing the extracellular matrix aspects, and...
Source: Romanian Journal of Morphology and Embryology - August 17, 2016 Category: Journals (General) Tags: Rom J Morphol Embryol Source Type: research

Acute stroke from paradoxical embolism of dense fibrous tissue following pacemaker lead extraction: salvation by mechanical thrombectomy
Key Clinical Message Systemic embolization is a dreaded complication of transvenous lead extraction (TLE), even without visible vegetations. Preoperative patent foramen ovale evaluation is important, justifying neurological surveillance or consideration of surgical extraction in selected cases. In case of stroke after TLE, mechanical thrombectomy is a successful therapy, and should be readily available. Systemic embolization is a dreaded complication of transvenous lead extraction (TLE), even without visible vegetations. Preoperative patent foramen ovale evaluation is important, justifying neurological surveillance or con...
Source: Clinical Case Reports - December 1, 2015 Category: Journals (General) Authors: Nicolas B. Dayal, Ana Paula Narata, Haran Burri Tags: Case Report Source Type: research

Closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack.
CONCLUSIONS: The combined data from recent RCTs have shown no statistically significant differences between TDC and medical therapy in the prevention of recurrent ischemic stroke. TDC closure was associated with an increased risk of atrial fibrillation but not with serious adverse events. PMID: 26346232 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 8, 2015 Category: Journals (General) Authors: Li J, Liu J, Liu M, Zhang S, Hao Z, Zhang J, Zhang C Tags: Cochrane Database Syst Rev Source Type: research

Persistent hypoxemia and platypnea-orthodeoxia after left single-lung transplantation: a case report
Conclusions Our case demonstrates that an open patent foramen ovale leading to massive right-to-left shunting is a possible complication after lung transplant, with significant morbidity, and that it can be treated successfully using a percutaneously placed occlusion device. Through this case report, we aim to improve pre-transplant procedures by demonstrating that a bubble contrast transesophageal echocardiogram can be performed pre-operatively to detect a patent foramen ovale.
Source: Journal of Medical Case Reports - June 12, 2015 Category: Journals (General) Source Type: research

A rare case of cryptogenic stroke with an incidental finding of patent foramen ovale.
PMID: 25876305 [PubMed - in process]
Source: Ir Med J - March 1, 2015 Category: Journals (General) Authors: Anglim B, Maher N, Cunningham O, Mulcahy D, Harbison J, O'Connell M Tags: Ir Med J Source Type: research

Patent foramen ovale and cryptogenic stroke: Many unanswered questions
Patent foramen ovale (PFO) is associated with cryptogenic stroke, but uncertainty remains about the exact relationship and the best management. Percutaneous closure of PFO is safe and effective, but this procedure has yet to be definitely proven to be better than medical therapy. The scenario of PFO and cryptogenic stroke poses unique challenges to primary care physicians and subspecialists and requires an understanding of the relationship between cryptogenic stroke and PFO, and of current data on the safety, efficacy, and comparative effectiveness of management options.
Source: Cleveland Clinic Journal of Medicine - July 1, 2014 Category: Journals (General) Authors: ROTH, C., ALLI, O. Tags: Review Source Type: research

Patent foramen ovale and the risk of cryptogenic stroke
Source: Cleveland Clinic Journal of Medicine - July 1, 2014 Category: Journals (General) Authors: TOBIS, J. Tags: Commentary Source Type: research

Patent foramen ovale (PFO) closure to prevent recurrent stroke in a patient with a nickel allergy.
This article reviews current management of PFO in association with cryptogenic stroke in light of the results of three recent randomized controlled trials and two meta-analyses of observational data. The article will also discuss circumstances which merit consideration for closure despite the negative trial data, and will review our management strategy for closure in this patient with a nickel allergy that precluded the use of the most commonly used PFO closure device. PMID: 24830118 [PubMed - in process]
Source: Connecticut Medicine - April 1, 2014 Category: Journals (General) Authors: Rizvi AA, Margey R, Kiernan F Tags: Conn Med Source Type: research

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