Transcatheter Closure of Patent Foramen Ovale: Randomized Trial Update

Interv Cardiol Clin. 2019 Oct;8(4):341-356. doi: 10.1016/j.iccl.2019.05.002. Epub 2019 Jul 27.

Abstract

A patent foramen ovale (PFO) is found in about one-quarter of all adults, but the prevalence increases to approximately half of those with a history of a so-called cryptogenic stroke. The true efficacy of PFO closure for prevention of recurrent paradoxical embolism has been debated for years, as the early 3 randomized trials did not show a statistically significant benefit of PFO closure over standard-of-care medical therapy. However, 3 recent randomized trials along with the long-term follow-up data from the largest early trial demonstrated superiority of device closure for secondary stroke prevention.

Keywords: Cryptogenic stroke; ESUS; Embolic stroke of undetermined source; PFO; PFO closure; Stroke prevention.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / methods*
  • Embolism, Paradoxical / etiology
  • Embolism, Paradoxical / prevention & control*
  • Foramen Ovale, Patent / complications
  • Foramen Ovale, Patent / surgery*
  • Humans
  • Randomized Controlled Trials as Topic / methods*
  • Risk Factors
  • Secondary Prevention / methods*
  • Septal Occluder Device*
  • Stroke / etiology
  • Stroke / prevention & control*
  • Treatment Outcome