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Patent foramen ovale

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https://www.readbyqxmd.com/read/28224399/can-neuroimaging-differentiate-pfo-and-af-related-cardioembolic-stroke-from-the-other-embolic-sources-clinical-radiological-correlation-on-a-retrospective-study
#1
Alessandro Stecco, Martina Quagliozzi, Eleonora Soligo, Andrea Naldi, Alessia Cassarà, Lorenzo Coppo, Roberta Rosso, Angelo Sante Bongo, Paola Amatuzzo, Francesco Buemi, Elena Guenzi, Alessandro Carriero
PURPOSE: The aim of this retrospective study was to map the specific ischemic lesion patterns of distribution in patent foramen ovale-related stroke (PFO-stroke) and atrial fibrillation-related stroke (AF-stroke) in patients with idiopatic ischemic stroke. MATERIALS AND METHODS: 750 ischaemic strokes were screened on basis of diagnostic imaging and tests: patients with known causes were excluded. 171 patients with unknown cause were selected and divided in two groups: AF-stroke (43 patients) and PFO-stroke (128 patients)...
February 21, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28212133/potential-uselessness-and-futility-of-left-atrial-appendage-occlusion-and-patent-foramen-ovale-closure-in-cardioembolic-stroke
#2
Gian L Nicolosi
International guidelines indicate that interventional closure of left atrial appendage and patent foramen ovale may be considered in selected patients for stroke prevention. These procedures appear, however, from the published literature, at high risk of uselessness and futility in the single case, if not even capable to induce harm and adverse events. In fact, all reported systematic reviews and meta-analyses have not shown in a convincing manner the superiority of these procedures in stroke prevention, taking into account the occurrence of possible complications also, as compared with alternative medical treatment...
February 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28202256/transseptal-puncture-review-of-anatomy-techniques-complications-and-challenges
#3
REVIEW
Barry O'Brien, Haroon Zafar, Simon De Freitas, Faisal Sharif
In recent years, the transseptal puncture approach has enabled passage of increasingly large and complex devices into the left atrium. Traditional tools remain effective in creating and dilating the initial puncture, with an acceptable safety profile. Even for skilled operators, the procedure is technically demanding and requires sound understanding of atrial anatomy. Intracardiac echocardiography is useful in cases of previous septal repair, poorly defined fossa ovalis anatomy or when considering patent foramen ovale portal crossing...
April 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28183551/cerebral-air-embolism-after-ercp
#4
Sonia Trabanco, Sara Pardo, Mónica Williams, Javier Diaz, Cristina Ruiz
Digestive endoscopic procedures have become increasingly common diagnostic and therapeutic procedures in hospitals. Generally they are safe procedures and complications, though infrequent, can occur and are potentially lethal. As the number of procedures performed increases, the complications arising are likely to become more frequent, so it is advisable to bear this in mind when establishing early diagnosis and treatment. Cerebral air embolism is a rare complication after a digestive endoscopic procedure, although in the case of endoscopic retrograde cholangiopancreatography (ERCP), may be as high as 10%...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28181217/hypercoagulability-and-migraine
#5
Gretchen E Tietjen, Stuart A Collins
BACKGROUND: A growing body of literature suggests that migraineurs, particularly those with aura, have an increased risk for ischemic stroke, but not via enhanced atherosclerosis. The theory that micro-emboli induced ischemia provokes cortical spreading depression (ie, symptomatic aura) in migraineurs but transient ischemic attacks in others highlights a potential role for hypercoagulability as a link between migraine (with aura) and stroke. AIM: Our objective is to summarize the literature evaluating the association of migraine with various acquired or inheritable thrombophilic states, including those related to elevated estrogen levels, endothelial activation and dysfunction, antiphospholipid antibodies (aPL), deficiency of coagulation inhibitors, and presence of certain genetic polymorphisms...
February 9, 2017: Headache
https://www.readbyqxmd.com/read/28176181/transthoracic-contrast-echocardiography-using-vitamin-b6-and-sodium-bicarbonate-as-contrast-agents-for-the-diagnosis-of-patent-foramen-ovale
#6
Jiang-Chun He, Jian-Yong Zheng, Xin Li, Ye Yang, Bo-Yang Zhang, Yu Chen, Xian-Feng Li, Ying-Ming Liu, Yi Cao, Li Zhao, Tian-Chang Li
To evaluate the utility of transthoracic contrast echocardiography (cTTE) using vitamin B6 and sodium bicarbonate as contrast agents for diagnosing right-to-left shunt (RLS) caused by patent foramen ovale (PFO) compared to that of transesophageal echocardiography (TEE). We investigated 125 patients admitted to our neurology department with unexplained cerebral infarction and migraine. All patients underwent cTTE using vitamin B6 and sodium bicarbonate as contrast agents, after which they underwent transthoracic echocardiography...
February 7, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28157747/cardioembolic-stroke
#7
Cumara B O'Carroll, Kevin M Barrett
PURPOSE OF REVIEW: Cardioembolic stroke is common and disproportionately more disabling than nonembolic mechanisms of stroke. Its incidence is expected to rise because of the age-related incidence of atrial fibrillation and an aging population. This article summarizes the different causes of cardioembolism and outlines current management guidelines. RECENT FINDINGS: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28154102/cryptogenic-stroke-research-and-practice
#8
Shadi Yaghi, Richard A Bernstein, Rod Passman, Peter M Okin, Karen L Furie
BACKGROUND: Cryptogenic stroke accounts for 30% to 40% of ischemic stroke. It is essential to determine the possible culprit because this will improve secondary stroke prevention strategies. METHODS: We performed a narrative nonsystematic review of the literature that included randomized trials, exploratory comparative studies, and case series on cryptogenic stroke. RESULTS: There are several possible mechanisms implicated in cryptogenic stroke, including occult paroxysmal atrial fibrillation, patent foramen ovale, aortic arch atherosclerosis, atrial cardiopathy, and substenotic atherosclerosis...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28151866/acute-arterial-embolism-of-left-lower-extremity-caused-by-paradoxical-embolism-in-ebstein-s-anomaly-a-case-report
#9
Jun-Sheng Li, Jie Ma, Zi-Xing Yan, Dong-Ming Cheng, Liang Chang, Hai-Chun Zhang, Jiang-Yan Liu
INTRODUCTION: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients' quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28123762/percutaneous-pfo-closure-for-cryptogenic-stroke-in-the-setting-of-a-systematic-cardiac-and-neurological-screening-and-a-standardised-follow-up-protocol
#10
Stéphane Noble, Robert F Bonvini, Fabio Rigamonti, Roman Sztajzel, Fabienne Perren, Philippe Meyer, Hajo Müller, Marco Roffi
BACKGROUND: There are no uniform workup and follow-up (FU) protocols for patients presenting with cryptogenic embolism (CE) who undergo percutaneous closure of a patent foramen ovale (PFO). METHODS: We prospectively performed a systematic cardiac and neurological FU protocol in all patients who underwent percutaneous PFO closure in order to assess the incidence of subsequent cardiac and neurological adverse events. All patients received dual antiplatelet therapy for 6 months and were systematically included in a 12-month standardised FU protocol including: clinical evaluation-transthoracic and transoesophageal echocardiography, 24-hour Holter monitoring and/or 1-week R-test, and transcranial Doppler...
2017: Open Heart
https://www.readbyqxmd.com/read/28116864/pfo-closure-end-of-an-era-or-beginning-of-a-new-chapter
#11
EDITORIAL
Mahmoud I Traina, E Murat Tuzcu
This large long-term retrospective cohort study shows that percutaneous patent foramen ovale (PFO) closure is safe. Higher rates of recurrent stroke or TIA were noted in older patients (age>55) and those with diabetes and hypertension Randomized trials have failed to show significant benefit from PFO closure for cryptogenic stroke though pooled analyses and longer-term follow-up have revealed significant reduction in recurrent strokes. Future studies and longer-term follow-up will need to elucidate which subgroups of patients will benefit from closure...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28111746/saddle-pulmonary-embolism-with-paradoxical-coronary-artery-embolism-through-a-patent-foramen-ovale
#12
Amber L Achesinski, Wendy M Gunther, Catherine B Pearman
A 35-year-old male patient was found in cardiac arrest in his vehicle, with no apparent injuries after a minor motor vehicle collision. The decedent was found to have a saddle pulmonary embolus with a thromboembolus impacted across a patent foramen ovale and a paradoxical embolism in the circumflex coronary artery, as well as significant clotting in the deep veins of both lower extremities. There were no risk factors in his history to explain the deep venous thrombosis; family history suggested the possibility of an unrecognized clotting disorder...
January 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28111139/double-outlet-right-ventricle-with-an-intact-interventricular-septum-and-concurrent-hypoplastic-left-ventricle-in-a-calf
#13
D K Newhard, S W Jung, R L Winter, T Kuca, J Bayne, T Passler
A 3-day-old Hereford heifer calf presented for evaluation of lethargy and dyspnea, with persistent hypoxia despite supplemental oxygen therapy. A grade III/VI right apical systolic murmur was noted during cardiac auscultation. Echocardiography revealed a double-outlet right ventricle with an intact interventricular septum and concurrent hypoplastic left ventricle and tricuspid valve dysplasia. Post-mortem examination revealed additional congenital anomalies of ductus arteriosus, patent foramen ovale, and persistent left cranial vena cava...
January 19, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/28106717/air-embolism-diagnosis-clinical-management-and-outcomes
#14
Colin J McCarthy, Sasan Behravesh, Sailendra G Naidu, Rahmi Oklu
Air embolism is a rare but potentially fatal complication of surgical procedures. Rapid recognition and intervention is critical for reducing morbidity and mortality. We retrospectively characterized our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical records were searched for all cases of air embolism over a 25-year period; relevant medical and imaging records were reviewed. Sixty-seven air embolism cases were identified; the mean age was 59 years (range, 3-89 years)...
January 17, 2017: Diagnostics
https://www.readbyqxmd.com/read/28106015/relationship-between-mean-platelet-volume-and-ischemic-stroke-in-patients-with-patent-foramen-ovale
#15
Nermin Bayar, Selçuk Küçükseymen, Zehra Erkal, Ramazan Güven, Erkan Köklü, Çağın Mustafa Üreyen, Şakir Arslan
OBJECTIVE: Patent foramen ovale (PFO) is commonly encountered in patients with cryptogenic stroke. Mean platelet volume (MPV), an indicator of platelet reactivity, has been reported in recent trials to be higher in patients with PFO than in normal population. The aim of this study was to investigate whether there is a difference in MPV between patients with PFO and stroke or transient ischemic attack (TIA) and that of patients with asymptomatic PFO. METHODS: Patients with PFO who were younger than 55 years of age were enrolled in this retrospective study...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28088807/posterior-versus-anterior-circulation-stroke-in-young-adults-a-comparative-study-of-stroke-aetiologies-and-risk-factors-in-stroke-among-young-fabry-patients-sifap1
#16
Bettina von Sarnowski, Ulf Schminke, Ulrike Grittner, Christian Tanislav, Tobias Böttcher, Michael G Hennerici, Turgut Tatlisumak, Jukka Putaala, Manfred Kaps, Franz Fazekas, Christian Enzinger, Arndt Rolfs, Christof Kessler
BACKGROUND: Although 20-30% of all strokes occur in the posterior circulation, few studies have explored the characteristics of patients with strokes in the posterior compared to the anterior circulation so far. Especially data on young patients is missing. METHODS: In this secondary analysis of data of the prospective multi-centre European sifap1 study that investigated stroke and transient ischemic attack (TIA) patients aged 18-55 years, we compared vascular risk factors, stroke aetiology, presence of white matter hyperintensities (WMH) and cerebral microbleeds (CMB) between patients with ischaemic posterior circulation stroke (PCS) and those having suffered from anterior circulation stroke (ACS) based on cerebral MRI...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28053539/complex-neurological-symptoms-in-bilateral-thalamic-stroke-due-to-percheron-artery-occlusion
#17
Paola Caruso, Paolo Manganotti, Rita Moretti
The artery of Percheron is a rare anatomical variant where a single thalamic perforating artery arises from the proximal posterior cerebral artery (P1 segment) between the basilar artery and the posterior communicating artery and supplies the rostral mesencephalon and both paramedian territories of the thalami. Almost one-third of human brains present this variant. Occlusion of the artery of Percheron mostly results in a bilateral medial thalamic infarction, which usually manifests with altered consciousness (including coma), vertical gaze paresis, and cognitive disturbance...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28028400/transcatheter-closure-of-patent-foramen-ovale-a-single-center-experience
#18
Ivan Milev, Planinka Zafirovska, Zan Zimbakov, Shpend Idrizi, Vilma Ampova-Sokolov, Emilija Gorgieva, Liljana Ilievska, Goce Tosheski, Nikola Hristov, Ljubica Georgievska-Ismail, Tanja Anguseva, Zan Mitrev
BACKGROUND: Percutaneous transcatheter closure (PTC) of patent foramen ovale (PFO) is implicated in cryptogenic stroke, transitional ischemic attack (TIA) and treatment of a migraine. AIM: Our goal was to present our experience in the interventional treatment of PFO, as well as to evaluate the short and mid-term results in patients with closed PFO. MATERIAL AND METHODS: Transcatheter closure of PFO was performed in 52 patients (67.3% women, mean age 40...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28024853/inferior-vena-cava-compression-as-a-novel-maneuver-to-detect-patent-foramen-ovale-a%C3%A2-transesophageal-echocardiographic-study
#19
Eiji Yamashita, Tomoyuki Murata, Eri Goto, Takeshi Fujiwara, Takehito Sasaki, Kentaro Minami, Kohki Nakamura, Koji Kumagai, Shigeto Naito, Kazuomi Kario, Shigeru Oshima
BACKGROUND: The Valsalva maneuver, the most sensitive test for patent foramen ovale (PFO) detection, is difficult during transesophageal echocardiography (TEE), especially after sedation. The aim of this study was to compare PFO detection effectiveness between inferior vena cava (IVC) compression and the Valsalva maneuver. METHODS: A total of 293 patients with paroxysmal atrial fibrillation undergoing TEE before initial atrial fibrillation ablation were prospectively enrolled...
December 23, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28024095/recent-development-of-transcatheter-closure-of-atrial-septal-defect-and-patent-foramen-ovale-with-occluders
#20
REVIEW
Baiyu Tang, Feng Su, Xiangke Sun, Qin Wu, Quansheng Xing, Suming Li
Atrial septal defect (ASD) and patent foramen ovale (PFO) are common clinical congenital heart defects. As an effective method for the treatment of ASD and PFO, transcatheter closure with occluders presents many advantages, including safety, ease of operation, minimal invasiveness, and reduced complications. This contribution reviews the various types of occluders currently used in clinical applications and under development, including non degradable occluders, partially degradable occluders, and totally degradable occluders...
December 26, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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