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Patent foramen ovale

Pil Hyung Lee, Jae-Kwan Song, Jong S Kim, Ran Heo, Sahmin Lee, Dae-Hee Kim, Jong-Min Song, Duk-Hyun Kang, Sun U Kwon, Dong-Wha Kang, Dongwhane Lee, Hyuk Sung Kwon, Sung-Cheol Yun, Byung Joo Sun, Jae-Hyeong Park, Jae-Hwan Lee, Hye Seon Jeong, Hee-Jung Song, Jei Kim, Seung-Jung Park
BACKGROUND: Recent reports showing the favorable role of patent foramen ovale (PFO) closure in patients with cryptogenic stroke have raised the issue of selecting optimal candidates. OBJECTIVES: We evaluated whether the benefits of PFO closure can be determined based on the morphologic characteristics of the PFO, as evaluated by transesophageal echocardiography. METHODS: Patients with cryptogenic stroke and high-risk PFO were divided between a transcatheter PFO closure and a medication-only group...
February 28, 2018: Journal of the American College of Cardiology
Brianna J Shinn, Laura J Tafe, Pantila Vanichakarn
BACKGROUND Carcinoid tumor, benign, low-grade malignant, and high-grade malignant, can be associated with the release of vasoactive substances that cause symptoms including cutaneous flushing, diarrhea, and bronchospasm. In 50-60% of patients with carcinoid syndrome, the vasoactive substances cause fibrosis of the pulmonary and tricuspid heart valves which lead to regurgitation and right-sided heart failure. The right side of the heart is usually affected because monoamine oxidases in the lungs usually inactivate the vasoactive substances...
March 12, 2018: American Journal of Case Reports
Yalcin Velibey, Baris Yaylak, Tolga Sinan Guvenc, Goksel Cinier, Koray Kalenderoglu, Ozge Guzelburc, Ozlem Yildirimturk
BACKGROUND: Temporary transvenous pacemaker implantation is an important and critical procedure for emergency physicians. Traditionally, temporary pacemakers are inserted by electrocardiography (ECG) guidance in the emergency department because fluoroscopy at the bedside in an unstable patient can be limited by time and equipment availability. However, in the presence of atrial septal defect, ventricular septal defect, and patent foramen ovale, the pacemaker lead can be implanted inadvertently into the left ventricle or directly into the coronary sinus instead of right ventricle...
March 6, 2018: Journal of Emergency Medicine
Babikir Kheiri, Ahmed Abdalla, Mohammed Osman, Sahar Ahmed, Mustafa Hassan, Ghassan Bachuwa
BACKGROUND: Cryptogenic strokes can be attributed to paradoxical emboli through patent foramen ovale (PFO). However, the effectiveness of PFO closure in preventing recurrent stroke is uncertain and the results of previous randomized clinical trials (RCTs) have been inconclusive. Hence, this study provides an updated meta-analysis of all RCTs comparing PFO closure with medical therapy for secondary prevention of cryptogenic stroke. METHODS: All RCTs were identified by a comprehensive literature search of PubMed, Embase, the Cochrane Collaboration Central Register of Controlled Trials, Scopus, and Clinicaltrials...
March 7, 2018: Cardiology Journal
Parth Bhatt, Achint Patel, Varun Kumar, Anusha Lekshminarayanan, Viranchi Patel, Srilatha Alapati, Zeenia Cyrus Billimoria
BACKGROUND: We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients. METHODS: We identified patients undergoing percutaneous closure of ASD with device using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.52 from the National Inpatient Sample, years 2002-2011. Patients with age ≤ 18 years and primary diagnosis code 745...
March 5, 2018: World Journal of Pediatrics: WJP
Jakob Kluge, Armin Grau
The value of interventional closure of patent foramen ovale (PFO) after cryptogenic stroke has been controversial. Recently, two randomized controlled trials showed a benefit of interventional closure of PFO compared to antiplatelet therapy only. We give a survey of the current literature and express questions that still remain unacknowledged.
March 2018: Deutsche Medizinische Wochenschrift
Bernhard Meier
A patent foramen ovale (PFO) is not to be considered a disease as it is present in about 25 % of people. Yet, it is the prime reason for paradoxical embolism that can cause serious problems, such as death, stroke, myocardial infarction, and peripheral ischemia. The frequency of such events is probably underestimated as other causes tend to be blamed for them. Device PFO closure can be easily accomplished as outpatient procedure with minimal discomfort and risk and it has been referred to as mechanical vaccination...
March 2018: Deutsche Medizinische Wochenschrift
Gianluca Rigatelli, Marco Zuin
Nowadays patent foramen ovale (PFO) closure is considered clinically beneficial and even cost-effective over medical therapy in secondary prevention of stroke due to paradoxical embolism. Areas covered: In this review, the authors discuss both anatomical and technical details and constructive concepts of current devices used for PFO closure. Expert commentary: Right atrial and interatrial septum anatomy is more complex than usually thought and a unique prosthesis that fits properly to all the possible morphologies is far from being designed...
March 9, 2018: Expert Review of Medical Devices
Hajime Ikenouchi, Naoto Sugeno, Takaaki Nakamura, Junpei Kobayashi, Ryuji Oshima, Hiroshi Kuroda, Masashi Aoki
Development of paradoxical cerebral embolism requires both unstable venous thrombosis and right-to-left shunt (RLS). Gastrointestinal endoscopy (GE) has the potential to affect intrathoracic and abdominal venous thrombi and to enhance RLS because the procedure alters intrathoracic and abdominal pressure. We describe a patient with Crohn's disease who developed paradoxical cerebral embolism after GE. Both an unstable venous thrombus in the superior vena cava and RLS through patent foramen ovale were thought to be responsible for the stroke...
February 28, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Volker Schulze, Yingfeng Lin, Athanasios Karathanos, Maximilian Brockmeyer, Tobias Zeus, Amin Polzin, Stefan Perings, Malte Kelm, Georg Wolff
BACKGROUND: Previous randomized controlled trials (RCT) failed to demonstrate benefits of patent foramen ovale (PFO) closure (PFO-C) over medical therapy (MT) for secondary prevention of cryptogenic ischemic stroke. Three recently published RCTs, however, turned out positive for PFO-C and warrant an updated meta-analysis. METHODS: Data from all available RCTs on PFO-C vs. MT for secondary prevention of cryptogenic ischemic stroke up until October 2017 were abstracted and analyzed in a comprehensive meta-analysis...
March 2, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Xin-Lin Zhang, Li-Na Kang, Lian Wang, Biao Xu
BACKGROUND: Patent foramen ovale (PFO) closure has emerged as a secondary prevention option in patients with PFO and cryptogenic stroke. However, the comparative efficacy and safety of percutaneous closure and medical therapy in patients with cryptogenic stroke and PFO remain unclear. METHODS: Randomized controlled trials (RCTs) and comparative observational studies that compared PFO closure against medical therapy, each with a minimal of 20 patients in the closure arm and 1-year follow-up were included...
March 2, 2018: BMC Cardiovascular Disorders
Mohammad K Mojadidi, Muhammad O Zaman, Islam Y Elgendy, Ahmed N Mahmoud, Nimesh K Patel, Nayan Agarwal, Jonathan M Tobis, Bernhard Meier
Nearly one-half of patients with cryptogenic stroke have a patent foramen ovale (PFO). The dilemma of whether to close these PFOs percutaneously, in an effort to reduce the risk of recurrent paradoxical embolism, has been a matter of ongoing debate for more than a decade. Early randomized clinical trials failed to demonstrate a significant benefit of percutaneous PFO closure for secondary prevention of cryptogenic stroke in an intention-to-treat analysis. The long-term follow-up data from the RESPECT trial and 2 new randomized trials (CLOSE and REDUCE) have clarified these findings...
March 6, 2018: Journal of the American College of Cardiology
Danica Cvetković, Vladimir Živković, Slobodan Nikolić
A 75-year-old woman was admitted to the emergency room with chest pain and vomiting. An electrocardiogram and laboratory results were suggestive for myocardial infarction of the posterior cardiac wall. Echocardiography was indicative of aortic dissection, and a CT scan of the thoracic arteries showed a massive pulmonary thromboembolism and thrombotic occlusion of the right coronary artery (RCA). The woman died shortly after admission. Autopsy confirmed the presence of thromboemboli in the right pulmonary artery and its lobar branches...
February 27, 2018: Forensic Science, Medicine, and Pathology
Matthew Grant, Samuel Douglass, Eric Roberge, Eric Shry
A 40 year-old athletic woman presented with worsening dyspnea on exertion over the preceding several months. Chest radiograph showed borderline cardiomegaly and subsequent echocardiography demonstrated a 5.0-cm left atrial mass as well as left-to-right interatrial shunting through a patent foramen ovale. Cardiac magnetic resonance imaging was performed, which demonstrated signal characteristics consistent with an atrial myxoma. The patient then underwent urgent surgical treatment with good technical and clinical outcome...
December 2017: Radiology Case Reports
Seema S Rao, Tyler L Scaff, John Gurley, Sibu Saha
Device therapy is a viable alternative to open heart surgery in the management of intracardiac defects. The Amplatzer septal occluder (ASO) is one such device that has been adapted to close a wide variety of cardiac defects with few complications and a high success rate. This is a retrospective review of all the patients who received the ASO between 2012 and 2016 at the University of Kentucky. In total, 169 patients underwent percutaneous closure of a septal defect with Amplatzer during the timeframe studied, and of those, 91% received the device for an atrial septal defect or patent foramen ovale...
March 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
R Wachter, K Gröschel
About a quarter of a million people in Germany suffer a stroke every year. Stroke is the most dreaded cardiovascular disease, even before myocardial infarction and heart failure. In the last two to three years, significant progress has been made in acute treatment, secondary prophylaxis in patients with patent foramen ovale, and the interdisciplinary evaluation of atrial fibrillation as the cause of the stroke. These new findings allow for more precise treatment.
February 19, 2018: Der Internist
Mateusz K Hołda, Mateusz Koziej, Katarzyna Piątek, Wiesława Klimek-Piotrowska
BACKGROUND: The left-sided atrial septal pouch (SP), a recently re-discovered anatomical structure within the human interatrial septum, has emerged as a possible source of thrombi formation and a trigger for atrial fibrillation, thereby potentially increasing the risk for ischemic stroke. In many studies, the swine interatrial septum has been used as model of the human heart. Also, possible new strategies and devices for management of the SPs may first be tested in this pig model. Therefore, in this study, we aimed to evaluate swine interatrial septum morphology and to compare it with the human analog, especially in the light of SP occurrence...
February 16, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Paolo Scacciatella, Ilaria Meynet, Mauro Giorgi, Lorenza M Biava, Ivana Matranga, Luigi Biasco, Pierluigi Omedè, Fulvio Orzan, Fiorenzo Gaita
OBJECTIVES: The purpose of this study is to compare the long-term outcomes of patent foramen ovale (PFO) closure using angiography or transesophageal echocardiography as procedural guidance. BACKGROUND: The interventional treatment is emerging as a safe and efficient option for patients with high likelihood of PFO-related cryptogenic stroke and high risk of recurrence. The "gold-standard" guidance technique remains an issue. METHODS: Two cohorts of patients undergoing PFO closure for cryptogenic stroke in two catheterization laboratories of the same institution, using similar inclusion criteria but different guidance, were compared with propensity score matching...
February 19, 2018: Echocardiography
M Ranjith, Prasanna Udupi Bidkar, K Narmadalakshmi, Praveen R Talawar
Background: Hemodynamic disturbances are common during positioning the patients from supine to sitting for neurosurgical procedures. The reported incidence of hypotension varies from 5% to 32%. The aim of the study was to study the effect of crystalloid preloading on hemodynamic parameters during positioning the patient from supine to sitting position. Materials and Methods: In this prospective observational trial, 20 patients were enrolled. Two patients had a patent foramen ovale on transesophageal echocardiography and were excluded from the study...
January 2018: Journal of Neurosciences in Rural Practice
Alexandros Kallifatidis, Christos Tourmousoglou, Gerasimos Gogas, Nikolaos Nikoloudakis, Antonis Pitsis
No abstract text is available yet for this article.
March 2018: Annals of Thoracic Surgery
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