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1

Furlan, A. J. "PFO Closure: CLOSURE." Stroke 44, no. 6, Supplement 1 (2013): S45—S47. http://dx.doi.org/10.1161/strokeaha.113.000975.

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2

Sievert, Horst, Stefan Bertog, and Kerstin Piayda. "PFO Closure." JACC: Cardiovascular Interventions 18, no. 12 (2025): 1538–39. https://doi.org/10.1016/j.jcin.2025.05.027.

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3

Giordano, M., G. Gaio, R. Marzullo, et al. "PERCUTANEOUS CLOSURE OF PATENT FORAMEN OVALE AFTER A FAILED DEVICE–CLOSURE ATTEMPT: A HIGH–VOLUME SINGLE CENTRE EXPERIENCE." European Heart Journal Supplements 26, Supplement_2 (2024): ii77. http://dx.doi.org/10.1093/eurheartjsupp/suae036.180.

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Abstract Introduction Persistence of patent foramen ovale (PFO) has been associated with cryptogenic stroke due to a paradoxical systemic embolism. In these cases, a percutaneous closure allows to decrease the risk of redo cerebral ischemic events. However, the presence of a complex anatomy might prevent a correct device–deployment with a high–risk o residual shunt and/or device embolization. We describe our experience about alternative technique after a failed device closure attempt. Methods We reviewed six cases wherein the device was not able to close effectively the PFO. In these cases, al
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4

Stoller, Nina, Maria M. Wertli, Alan G. Haynes, et al. "Large regional variation in cardiac closure procedures to prevent ischemic stroke in Switzerland a population-based small area analysis." PLOS ONE 19, no. 1 (2024): e0291299. http://dx.doi.org/10.1371/journal.pone.0291299.

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Background Percutaneous closure of a patent foramen ovale (PFO) or the left atrial appendage (LAA) are controversial procedures to prevent stroke but often used in clinical practice. We assessed the regional variation of these interventions and explored potential determinants of such a variation. Methods We conducted a population-based analysis using patient discharge data from all Swiss hospitals from 2013–2018. We derived hospital service areas (HSAs) using patient flows for PFO and LAA closure. We calculated age-standardized mean procedure rates and variation indices (extremal quotient [EQ]
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5

Marzullo, R., G. Gaio, M. Giordano, et al. "P51 PERCUTANEOUS CLOSURE OF PATENT FORAMEN OVALE IN CHILDREN :SINGLE CENTER EXPERIENCE." European Heart Journal Supplements 25, Supplement_D (2023): D59. http://dx.doi.org/10.1093/eurheartjsupp/suad111.137.

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Abstract Background Transcatheter patent foramen ovale (PFO) closure is a validated strategy to prevent recurrent cerebral events in adult patients; limited data are available for children. Methods This is a retrospective analysis including pediatric population underwent to percutaneous treatment of PFO in our center. Results From 2006 to 2021, 21 transcatheter PFO closures have been performed in children (mean age: 14 +3 years; female: 58%, weight: 59 + 20 kg). Indications for the closure of PFO consisted in the occurrence of cryptogenic ischemic events for 18 patients (86%), in disabling mig
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6

Alkhouli, Mohamad, Horst Sievert, and David R. Holmes. "Patent foramen ovale closure for secondary stroke prevention." European Heart Journal 40, no. 28 (2019): 2339–50. http://dx.doi.org/10.1093/eurheartj/ehz157.

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Abstract Transcatheter closure of patent foramen ovale (PFO) in patients with cryptogenic stroke is gaining momentum after the recent publication of four randomized clinical trials suggesting its benefit. This article provides a contemporary overview of the anatomy and pathophysiology of PFO, the available diagnostic tools for the assessment and risk stratification of PFO, and the current and future landscape of PFO closure devices and their optimal utilization. It also summarizes the current data on PFO closure for stroke prevention, and discusses the remaining open issues in the field of PFO
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7

Wadile, Santosh, Moreshwar BA, and Snehal K. "Role of Closure of Patent Foramen Ovale in Children with Cryptogenic Stroke: Incidence, Evidence and Guidelines." Open Access Journal of Cardiology 8, no. 1 (2024): 1–3. http://dx.doi.org/10.23880/oajc-16000206.

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Patent foramen ovale (PFO) is post-natal persistence of interatrial communication and have shown to have association with various clinical manifestations including transient ischemic attack and strokes. The diagnosis of PFO requires transthoracic and transesophageal Echocardiogram. Closure of PFO with percutaneous device closure can prevent recurrence of strokes in selected patients with cryptogenic stroke and it has been included in recent guidelines also. In this mini review, we will discuss couple of cases of PFO closures followed by discussion upon recent guidelines on the same.
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8

Noble, Stéphane. "PFO Closure and Migraine." JACC: Cardiovascular Interventions 13, no. 3 (2020): 303–5. http://dx.doi.org/10.1016/j.jcin.2019.10.033.

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9

Kenny, Damien, Mark Turner, and Rob Martin. "PFO closure in children." Catheterization and Cardiovascular Interventions 71, no. 5 (2008): 715. http://dx.doi.org/10.1002/ccd.21492.

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10

arjat-Pasos, Julio I., Jorge Nuche, Jules Mesnier, et al. "Transcatheter Patent Foramen Ovale Closure in Stroke Patients with Thrombophilia: Current Status and Future Perspectives." Journal of Stroke 24, no. 3 (2022): 335–44. http://dx.doi.org/10.5853/jos.2022.01697.

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Transcatheter patent foramen ovale (PFO) closure is a safe and effective treatment for secondary prevention after a PFO-associated stroke as demonstrated in multiple large randomized clinical trials. However, these trials excluded a significant proportion of patients who could have benefited from percutaneous PFO closure due to coexisting potential confounders such as additional thromboembolic risk factors, namely thrombophilia. Since scarce and conflicting data existed on such patients, current clinical management guidelines on patients with PFO mainly recommended against PFO closure in patie
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11

Garg, Aakash, Mohammed Thawabi, Amit Rout, Chris Sossou, Marc Cohen, and John B. Kostis. "Recurrent Stroke Reduction with Patent Foramen Ovale Closure versus Medical Therapy Based on Patent Foramen Ovale Characteristics: A Meta-Analysis of Randomized Controlled Trials." Cardiology 144, no. 1-2 (2019): 40–49. http://dx.doi.org/10.1159/000500501.

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Efficacy of patent foramen ovale (PFO) closure in patients with cryptogenic stroke remains a matter of debate. We performed a comprehensive meta-analysis of available randomized controlled trials (RCTs) to evaluate the efficacy and safety of PFO closure versus medical therapy (MT) based on PFO characteristics. Random-effects meta-analysis was conducted to estimate risk ratio (RR) with 95% confidence intervals (CI) for the primary end points of stroke. After systematic search, six RCTs (3,747 patients) with 1,889 patients randomized to PFO closure and 1,858 patients randomized to the MT group w
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12

Giblett, Joel P., Omar Abdul-Samad, Leonard M. Shapiro, Bushra S. Rana, and Patrick A. Calvert. "Patent Foramen Ovale Closure in 2019." Interventional Cardiology Review 14, no. 1 (2019): 34–41. http://dx.doi.org/10.15420/icr.2018.33.2.

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Patent foramen ovale (PFO) is a common abnormality affecting between 20% and 34% of the adult population. For most people it is a benign finding; however, in some the PFO can open widely, enabling a paradoxical embolus to transit from the venous to arterial circulation, which is associated with stroke and systemic embolisation. Percutaneous closure of PFO in patients with cryptogenic stroke has been undertaken for a number of years, and a number of purpose-specific septal occluders have been marketed. Recent randomised controlled trials have demonstrated that closure of PFO in patients with cr
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13

Farjat-Pasos, Julio I., Angel Chamorro, Sylvain Lanthier, et al. "Cerebrovascular Events in Older Patients With Patent Foramen Ovale: Current Status and Future Perspectives." Journal of Stroke 25, no. 3 (2023): 338–49. http://dx.doi.org/10.5853/jos.2023.01599.

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Patent foramen ovale (PFO) closure, along with medical therapy, has emerged as the therapeutic gold standard in younger (<60-year-old) patients with a PFO-related stroke for preventing recurrent events. However, PFO management guidelines lack definite recommendations for older (>60 years) patients with a PFO-related cerebrovascular event, a complex group of patients who were mostly excluded from PFO closure clinical trials. Nevertheless, several studies have shown a higher prevalence of PFO among older patients with cryptogenic stroke, and its presence has been associated with an increas
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14

Kibler, Marion, Halim Marzak, Laurence Jesel, and Patrick Ohlmann. "High-grade atrioventricular block occurring during percutaneous closure of patent foramen ovale: a case report." European Heart Journal - Case Reports 4, no. 4 (2020): 1–5. http://dx.doi.org/10.1093/ehjcr/ytaa141.

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Abstract Background Percutaneous closure of patent foramen ovale (PFO) is recommended for patients presenting with PFO-related stroke. Acute high-grade conduction disturbances occurring during PFO closure procedure have not been previously reported. Case summary We describe for the first time a case of reversible complete atrioventricular block which occurred during closure of a PFO. Discussion We hypothesized that the block was the result of atrioventricular node compression—likely caused by the right-atrial disc of the 35-mm PFO closure device. We suggest implanting smaller devices in order
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15

Mir, Hassan, Reed Alexander C. Siemieniuk, Long Cruz Ge, et al. "Patent foramen ovale closure, antiplatelet therapy or anticoagulation in patients with patent foramen ovale and cryptogenic stroke: a systematic review and network meta-analysis incorporating complementary external evidence." BMJ Open 8, no. 7 (2018): e023761. http://dx.doi.org/10.1136/bmjopen-2018-023761.

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ObjectiveTo examine the relative impact of three management options in patients aged <60 years with cryptogenic stroke and a patent foramen ovale (PFO): PFO closure plus antiplatelet therapy, antiplatelet therapy alone and anticoagulation alone.DesignSystematic review and network meta-analysis (NMA) supported by complementary external evidence.Data sourcesMedline, EMBASE and Cochrane CENTRAL.Study selectionRandomised controlled trials (RCTs) addressing PFO closure and/or medical therapies in patients with PFO and cryptogenic stroke.Review methodsWe conducted an NMA complemented with externa
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16

Deng, W., T. Wickham, D. McMullin, et al. "MP6: HOMOCYSTEINE LEVEL IN PFO RELATED STROKE PATIENTS WITH RESPECT TO MEDICAL THERAPY VS PFO CLOSURE." Journal of Investigative Medicine 64, no. 3 (2016): 806.3–807. http://dx.doi.org/10.1136/jim-2016-000080.18.

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Purpose of StudyHomocysteine is an independent risk factor of ischemic stroke by promoting vascular endothelial dysfunction and thrombotic process through oxidative stress. We previously found that PFO closure may reduce total homocysteine level (tHcy) in plasma. Here, we compare the effect of PFO closure and medical treatment in reducing mild homocysteinemia in PFO-related stroke patients.Methods Used28 PFO-related stroke patients with mildly elevated tHcy (>12 µmol/l) were prospectively recruited in accordance with IRB. 14 received PFO closure and 14 were treated by medical therapy (antip
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17

Tariq, Muhammad Bilal, Syed Kalimullah S. Qadri, Anjail Sharrief, et al. "Heart Brain Clinic." Neurology: Clinical Practice 13, no. 6 (2023): e200206. http://dx.doi.org/10.1212/cpj.0000000000200206.

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Background and ObjectivesMultidisciplinary clinics have been shown to improve care. Patients with patent foramen ovale (PFO)–associated stroke need evaluation by cardiology and neurology specialists. We report our experience creating a multidisciplinary Structural Heart Brain Clinic (HBC) with a focus on patients with PFO-associated stroke.MethodsDemographic and clinical data were retrospectively collected for patients with PFO-associated ischemic stroke. Patients with PFO-associated stroke were divided into a standard care group and Heart Brain Clinic group for analysis. Outcome measures incl
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18

Deng, W., D. McMullin, T. Wickham, et al. "15: PFO CLOSURE REDUCES PLASMA LEVELS OF SEROTONIN IN A LONG TERM FOLLOWUP OF STROKE PATIENTS." Journal of Investigative Medicine 64, no. 3 (2016): 812.3–813. http://dx.doi.org/10.1136/jim-2016-000080.31.

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Purpose of StudyPFO allows venous clots and vasoactive factors to bypass pulmonary filtration and remain in circulation. We previously identified an immediate reduction of procoagulant serotonin (5-HT) in left atrial blood post PFO closure. To understand the long-term effect of PFO closure, we report the change of 5-HT in peripheral venous blood in 1-year followup.Methods Used97 PFO-related stroke patients were recruited on IRB approval. Venous blood was collected at baseline (BL) and 1 year follow-up (FU) of treatments (PFO closure and medical therapy). Plasma 5-HT was quantified by mass spec
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19

Edvinsson, Björn, Ulf Thilén, Niels Erik Nielsen, et al. "Does persistent (patent) foramen ovale closure reduce the risk of recurrent decompression sickness in scuba divers?" Diving and Hyperbaric Medicine Journal 51, no. 1 (2021): 63–67. http://dx.doi.org/10.28920/dhm51.1.63-67.

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Introduction: Interatrial communication is associated with an increased risk of decompression sickness (DCS) in scuba diving. It has been proposed that there would be a decreased risk of DCS after closure of the interatrial communication, i.e., persistent (patent) foramen ovale (PFO). However, the clinical evidence supporting this is limited. Methods: Medical records were reviewed to identify Swedish scuba divers with a history of DCS and catheter closure of an interatrial communication. Thereafter, phone interviews were conducted with questions regarding diving and DCS. All Swedish divers who
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20

Deng, Wenjun, David McMullin, Ignacio Inglessis-Azuaje, et al. "Effect of Patent Foramen Ovale Closure After Stroke on Circulatory Biomarkers." Neurology 97, no. 2 (2021): e203-e214. http://dx.doi.org/10.1212/wnl.0000000000012188.

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ObjectiveTo determine the influence of patent foramen ovale (PFO) closure on circulatory biomarkers.MethodsConsecutive patients with PFO-related stroke were prospectively enrolled and followed with serial sampling of cardiac atrial and venous blood pre- and post-PFO closure over time. Candidate biomarkers were identified by mass spectrometry in a discovery cohort first, and lead candidates were validated in an independent cohort.ResultsPatients with PFO-related stroke (n = 254) were recruited and followed up to 4 years (median 2.01; interquartile range 0.77–2.54). Metabolite profiling in the d
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21

Kottoor, Santhosh J., and Rohit R. Arora. "Cryptogenic Stroke: To Close a Patent Foramen Ovale or Not to Close?" Journal of Central Nervous System Disease 10 (January 2018): 117957351881947. http://dx.doi.org/10.1177/1179573518819476.

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A patent foramen ovale (PFO) has been shown to be highly prevalent in patients diagnosed with strokes of unknown cause, which are also called cryptogenic strokes (CSs). It has been a long-running controversy as to whether a PFO should be closed or not to prevent recurrent strokes in patients diagnosed with CS. A paradoxical embolism that is produced through a PFO is hypothesized to be a leading cause of CS, especially in younger patients with low risk factors for stroke. It remains controversial as to which anticoagulation therapy, defined as antithrombin or antiplatelet therapy, is better for
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22

Schulz, Antonia, Telse Hauschild, and Franz X. Kleber. "Possible spontaneous PFO closure after thrombus trapped in PFO." Clinical Research in Cardiology 103, no. 4 (2014): 333–35. http://dx.doi.org/10.1007/s00392-013-0655-1.

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23

Schwedt, TJ, BM Demaerschalk, and DW Dodick. "Patent Foramen Ovale and Migraine: A Quantitative Systematic Review." Cephalalgia 28, no. 5 (2008): 531–40. http://dx.doi.org/10.1111/j.1468-2982.2008.01554.x.

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Initial studies indicate an increased prevalence of patent foramen ovale (PFO) in migraineurs with aura, and an increased prevalence of migraine and migraine with aura in persons with PFO. Retrospective analyses of PFO closure suggest clinically significant improvements in migraine patterns. The aim of this study was to examine the prevalence of migraine in patients with PFO, the prevalence of PFO in migraineurs, and the effect of PFO closure on migraine. We conducted a quantitative systematic review of articles on migraine and PFO that met inclusion criteria, then reviewed, appraised, and sub
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24

Gong, Jie, Huayong Zhang, Changjian Li, and Yong Zhang. "Diagnosis and treatment of 2 cases with cryptogenic stroke due to patent foramen ovale in children: A case report." Medicine 103, no. 40 (2024): e39986. http://dx.doi.org/10.1097/md.0000000000039986.

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Rationale: Arterial ischemic stroke is a general term for necrosis of brain tissue due to insufficient blood supply to the brain from various causes. About 30% of these cases are of unknown origin and are known as cryptogenic strokes (CS). Patient concerns: We report 2 female patients, one 5 years and 5 months old and the other 6 years old. Both children had clinical manifestations of CS, and after ruling out other possible etiologies, we finally suspected that CS was associated with patent foramen ovale (PFO). Diagnoses: Case 1 was diagnosed with PFO, paradoxical embolism, and third-degree at
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25

Lee, Pil Hyung, Jung-Sun Kim, Jae-Kwan Song, et al. "Device Closure or Antithrombotic Therapy After Cryptogenic Stroke in Elderly Patients With a High-Risk Patent Foramen Ovale." Journal of Stroke 26, no. 2 (2024): 242–51. http://dx.doi.org/10.5853/jos.2023.03265.

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Background and Purpose In young patients (aged 18–60 years) with patent foramen ovale (PFO)- associated stroke, percutaneous closure has been found to be useful for preventing recurrent ischemic stroke or transient ischemic attack (TIA). However, it remains unknown whether PFO closure is also beneficial in older patients.Methods Patients aged ≥60 years who had a cryptogenic stroke and PFO from ten hospitals in South Korea were included. The effect of PFO closure plus medical therapy over medical therapy alone was assessed by a propensity-score matching method in the overall cohort and in those
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26

Darmoch, Fahed, Yasser Al-Khadra, Mohamad Soud, Zaher Fanari, and M. Chadi Alraies. "Transcatheter Closure of Patent Foramen Ovale versus Medical Therapy after Cryptogenic Stroke: A Meta-Analysis of Randomized Controlled Trials." Cerebrovascular Diseases 45, no. 3-4 (2018): 162–69. http://dx.doi.org/10.1159/000487959.

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Background: Patent foramen ovale (PFO) with atrial septal aneurysm is suggested as an important potential source for cryptogenic strokes. Percutaneous PFO closure to reduce the recurrence of stroke compared to medical therapy has been intensely debated. The aim of this study is to assess whether PFO closure in patients with cryptogenic stroke is safe and effective compared with medical therapy. Method: A search of PubMed, Medline, and Cochrane Central Register from January 2000 through September 2017 for randomized controlled trails (RCT), which compared PFO closure to medical therapy in patie
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27

Jin, X., Y. M. Hummel, W. T. Tay, et al. "Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale." Netherlands Heart Journal 29, no. 7-8 (2021): 402–8. http://dx.doi.org/10.1007/s12471-021-01543-0.

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Abstract Background Transcatheter atrial septal defect (ASD) and patent foramen ovale (PFO) closure might have opposite short- and long-term haemodynamic consequences compared with restricted interatrial shunt creation, which recently emerged as a potential treatment modality for patients with heart failure with preserved ejection fraction (HFpEF). Given the opposing approaches of ASD and PFO closure versus shunt creation, we investigated the early and sustained cardiac structural and functional changes following transcatheter ASD or PFO closure. Methods In this retrospective study, adult secu
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Singh, Harsimran S., Farhan Katchi, and Srihari S. Naidu. "PFO Closure for Cryptogenic Stroke." Cardiology in Review 25, no. 4 (2017): 147–57. http://dx.doi.org/10.1097/crd.0000000000000148.

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29

Mi, Michael Y., Peter C. Block, and Joseph P. Broderick. "PFO Closure for Cryptogenic Stroke." New England Journal of Medicine 378, no. 17 (2018): 1639–42. http://dx.doi.org/10.1056/nejmclde1715853.

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30

Luft, Andreas R. "Closing PFO closure for migraine?" European Heart Journal 37, no. 26 (2016): 2037–39. http://dx.doi.org/10.1093/eurheartj/ehw088.

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31

Flores-Umanzor, Eduardo, Rajesh Keshvara, Tahira Redwood, Mark Osten, Lusine Abrahamyan, and Eric Horlick. "Atrial Fibrillation Post-PFO Closure." JACC: Cardiovascular Interventions 15, no. 23 (2022): 2452. http://dx.doi.org/10.1016/j.jcin.2022.09.047.

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32

SCHWERZMANN, M., and O. SALEHIAN. "Hazards of percutaneous PFO closure." European Journal of Echocardiography 6, no. 6 (2005): 393–95. http://dx.doi.org/10.1016/j.euje.2005.09.007.

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33

Butman, Samuel. "PFO Closure: Trying the Trials." Catheterization and Cardiovascular Interventions 82, no. 6 (2013): 976. http://dx.doi.org/10.1002/ccd.25211.

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Balfour, P. J. P., D. Murphy, R. W. Troughton, and J. W. H. Blake. "PFO Closure – The Christchurch Experience." Heart, Lung and Circulation 22, no. 7 (2013): 551. http://dx.doi.org/10.1016/j.hlc.2013.04.010.

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35

Tobis, Jonathan M. "PFO Device Closure Despite Thrombophilia." JACC: Cardiovascular Interventions 16, no. 11 (2023): 1367–68. http://dx.doi.org/10.1016/j.jcin.2023.05.011.

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Fortuni, Federico, Giuseppe Ciliberti, and Filippo Zilio. "Supraventricular Arrhythmias After PFO Closure." JACC: Cardiovascular Interventions 16, no. 3 (2023): 360. http://dx.doi.org/10.1016/j.jcin.2022.12.007.

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37

Häusler, Karl Georg, and Hermann Neugebauer. "Verschluss des persistierenden Foramen ovale nach ischämischem Schlaganfall." DMW - Deutsche Medizinische Wochenschrift 144, no. 22 (2019): 1561–69. http://dx.doi.org/10.1055/a-0832-5767.

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AbstractSecondary prevention of otherwise cryptogenic stroke in patients with patent foramen ovale (PFO) has been a matter of debate over nearly three decades. Main issues were that data essentially derived from case-control-studies for a long period and that results from the randomized controlled trials CLOSURE-I, PC Trial and RESPECT, which were published in 2012 and 2013, were interpreted in different ways. The likewise not blinded randomized controlled trials REDUCE, CLOSE and DEFENSE-PFO, which were published in 2017 and 2018, consistently demonstrated superiority of interventional PFO cl
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Devos, Perrine, Paul Guedeney, and Gilles Montalescot. "Patent Foramen Ovale Percutaneous Closure: Evolution and Ongoing Challenges." Journal of Clinical Medicine 13, no. 1 (2023): 54. http://dx.doi.org/10.3390/jcm13010054.

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Patent foramen ovale (PFO) concerns nearly a quarter of the general population and incidence may reach up to 50% in patients with cryptogenic stroke. Recent randomized clinical trials confirmed that percutaneous closure of PFO-related stroke reduces the risk of embolic event recurrence. PFO also comes into play in other pathogenic conditions, such as migraine, decompression sickness or platypnea–orthodeoxia syndrome, where the heterogeneity of patients is high and evidence for closure is less well-documented. In this review, we describe the current indications for PFO percutaneous closure and
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Milev, Ivan, Planinka Zafirovska, Zan Zimbakov, et al. "Transcatheter Closure of Patent Foramen Ovale: A Single Center Experience." Open Access Macedonian Journal of Medical Sciences 4, no. 4 (2016): 613–18. http://dx.doi.org/10.3889/oamjms.2016.113.

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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 40.7 ± 11.7 years). Patients were interviewed for subjective grading of the intensity of headaches before and after the PFO closure.RESULTS: During
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40

Pirahanchi, Yasaman, Ben Shifflett, Ehtisham Mahmud, et al. "Abstract 61: (PFO-ACCESS): Augmenting Communications for medical care or Closure in the Evaluation of Stroke patients with cardiac Shunts." Stroke 56, Suppl_1 (2025). https://doi.org/10.1161/str.56.suppl_1.61.

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Introduction: Patent Foramen Ovale (PFO) contributes to a quarter of Embolic strokes of Undetermined Source (ESUS). Although benefit of PFO closure in selected patients has been demonstrated, our workflow resulted in a low rate of PFO evaluation for closure. The aim of the PFO-ACCESS program (which included implementation of the Viz.ai PFO-specific communications module) was to determine any change in PFO management due to improved communication between stroke and interventional cardiology (IC) teams. Methods: In this Quality Improvement (QI) project, we compared pre-PFO ACCESS (12/22-11/23) t
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Pirahanchi, Yasaman, Benjamin Shifflett, Ehtisham Mahmud, et al. "PFO‐ACCESS: Augmenting Communications for Medical Care or Closure in the Evaluation of Patients With Stroke With Cardiac Shunts." Stroke: Vascular and Interventional Neurology, February 4, 2025. https://doi.org/10.1161/svin.124.001707.

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BACKGROUND Patent foramen ovale (PFO) contributes to a quarter of embolic strokes of undetermined source. Although the benefit of PFO closure in selected patients has been demonstrated, our system workflow still resulted in a low rate of PFO evaluation for closure. The aim of the PFO‐ACCESS (Augmenting Communications for Medical Care or Closure in the Evaluation of Stroke Patients With Cardiac Shunts) program (which included implementation of the Viz.ai PFO‐specific communications module) was to determine if there was any change in PFO management due to improved communication between stroke an
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42

Trabattoni, Daniela, and Giulia Iannaccone. "PFO percutaneous closure: indications, safety issues and prognosis." July 4, 2021. https://doi.org/10.5281/zenodo.5068600.

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Patent foramen ovale (PFO) is a very common congenital heart disease, affecting 20-30% of general population [1].  Despite PFO diagnosis may be incidental and most patients  remain asymptomatic for a lifetime, over the last decades it has become clearer that PFO may be implicated in the pathogenesis of several medical conditions. In fact, PFO has been associated to a wide spectrum of clinical presentations which effects vary from a reduction of the quality of life (QoL) to life-threatening events. Among clinical conditions occurring in PFO patients, the most widely described are cryp
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Randhawa, Sandeep, Jawahar L. Mehta, and Gaurav Dhar. "Percutaneous Patent Foramen Ovale Closure: Stroke and Beyond." Current Cardiology Reviews 20 (March 11, 2024). http://dx.doi.org/10.2174/011573403x276984240304044109.

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Abstract: Over 750,000 individuals suffer from stroke annually in the United States, with 87% of these strokes being ischemic in nature. Roughly 40% of ischemic strokes occur in individuals 60 years of age or under. A quarter of all ischemic strokes have no identifiable cause despite extensive workup and are deemed cryptogenic in nature. Patent Foramen Ovales (PFO) has been postulated in stroke causation by either paradoxical embolization or platelet activation in the tunnel of the defect. The incidence of PFO is reported to be 15-25% in the general population but rises to 40% in patients with
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Skibsted, Christian Valdemar, Kasper Korsholm, Lars Pedersen, Kasper Bonnesen, Jens Erik Nielsen-Kudsk, and Morten Schmidt. "Long-term risk of atrial fibrillation or flutter after transcatheter patent foramen ovale closure: a nationwide Danish study." European Heart Journal, June 3, 2023. http://dx.doi.org/10.1093/eurheartj/ehad305.

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Abstract Aims Transcatheter closure of patent foramen ovale (PFO) is the recommended stroke prevention treatment in patients ≤60 years with cryptogenic ischemic stroke and PFO. Atrial fibrillation or flutter (AF) is a known potential procedure-related complication, but long-term risk of developing AF remains unknown. This paper studied the long-term risk of developing AF following PFO closure. Methods and results A Danish nationwide cohort study was conducted. During 2008–2020, this study identified a PFO closure cohort, a PFO diagnosis cohort without PFO closure, and a general population comp
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Harm, Tobias, Monika Zdanyte, Andreas Goldschmied, et al. "Pre-interventional transesophageal echocardiography as a reliable predictor of residual shunt following patent foramen ovale closure." Clinical Research in Cardiology, July 24, 2025. https://doi.org/10.1007/s00392-025-02713-5.

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Abstract Background Closure of a patent foramen ovale (PFO) is an effective strategy in the prevention of recurrent stroke after cryptogenic stroke. Residual shunt (RS) is a common issue following PFO closure and may affect safety and efficacy. Transesophageal echocardiography (TEE) is the key diagnostic tool, but standardized assessment of morphological parameters to prevent RS remains challenging. Aims In this study, we investigate the diagnostic value of different anatomical parameters assessed by TEE to predict RS after PFO closure. Methods We consecutively enrolled five-hundred and twenty
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46

Giordano, Mario, Gianpiero Gaio, Raffaella Marzullo, et al. "Patent foramen ovale closure with NobleStitch EL system in a case of Ebstein's anomaly after a failed device closure attempt." Journal of Cardiovascular Medicine, April 11, 2024. http://dx.doi.org/10.2459/jcm.0000000000001615.

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In the setting of an Ebstein's anomaly, a right-to-left shunt via a patent foramen ovale (PFO) may be the cause of a significant cyanosis. In these patients, the PFO closure is able to improve the arterial saturation. Furthermore, a partial closure is often recommended to obtain a reduction in the PFO right-left shunt without a significant impact on the right chamber hemodynamics. However, in some cases, a complex PFO anatomy may prevent an effective device closure. We describe the case of a patient with Ebstein's anomaly and a significant cyanosis due to a right-to-left shunt via the PFO wher
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Shin, Yonghoon, Albert Youngwoo Jang, Yoonsun Won, et al. "Long-term clinical outcomes for patients with uncrossable patent foramen ovale." Frontiers in Cardiovascular Medicine 10 (October 13, 2023). http://dx.doi.org/10.3389/fcvm.2023.1249259.

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IntroductionPatent foramen ovale (PFO) closure is performed in selected patients with cryptogenic stroke to prevent recurrence. The prognosis of patients with uncrossable PFO after failed guidewire or catheter passage during the procedure remains unknown. We compared the long-term prognosis between uncrossable PFO and successful PFO closure in patients with high-grade PFO shunts.MethodsWe analyzed patients who underwent PFO closure for stroke or transient ischemic attack (TIA) prevention at Gachon University Gil Medical Center between April 2010 and March 2022. The primary outcome was a compos
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Lange, Mathias. "PFO Closure and Stroke." Deutsches Aerzteblatt Online, January 26, 2018. http://dx.doi.org/10.3238/arztebl.2018.0056b.

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Dong, Bosi, Xin Li, Lu Zhang, et al. "Effects of patent foramen ovale in migraine: a metabolomics‐based study." Journal of Physiology, January 21, 2025. https://doi.org/10.1113/jp286772.

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AbstractPatent foramen ovale (PFO), a cardiac anatomical anomaly inducing abnormal haemodynamics, leads to a paradoxical bypass of the pulmonary circulation. PFO closure might alleviate migraines; however, clinical evidence and basic experiments for the relationship are lacking. To explore the effect of PFO on migraine, 371 migraineurs finishing blood tests and contrast transthoracic echocardiography for the detection of PFO were prospectively included. Multivariate regression analysis revealed that PFO was independently associated with aura, and lower cystatin‐C (cys‐C) and calcium levels. Am
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Dearani, Joseph A., Baran S. Ugurlu, Gordon K. Danielson, et al. "Surgical Patent Foramen Ovale Closure for Prevention of Paradoxical Embolism–Related Cerebrovascular Ischemic Events." Circulation 100, suppl_2 (1999). http://dx.doi.org/10.1161/circ.100.suppl_2.ii-171.

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Background —The role of surgical closure of patent foramen ovale (PFO) for cerebral infarction (CI) or transient ischemic attack (TIA) resulting from paradoxical embolism is unclear, and its effect on recurrence is unknown. Our objective was to determine the outcome of surgical closure of PFO in patients with a prior ischemic neurological event, define the rate of CI or TIA recurrence after PFO closure, and identify risk factors for these recurrences. Methods and Results —We retrospectively analyzed 91 patients (58 men, 33 women) with ≥1 previous cerebrovascular ischemic events who underwent s
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