Current management of patients with patent foramen ovale and cryptogenic stroke: our experience and review of the literature

BACKGROUND: Patent Foramen Ovale (PFO) occurs in approximately 25% of the population and has been implicated in the etiology of cryptogenic stroke. Although the exact mechanism of PFO's role in stroke has not been defined, there is a growing body of evidence that supports both the safety and therapeutic benefit of PFO closure in cryptogenic stroke. Current methods of therapy include anticoagulation, surgical closure, and percutaneous closure. METHODS: We completed a retrospective analysis of data from the first 20 PFO closures at our institution and evaluated the current literature on PFO treatment. RESULTS: Percutaneous closure had a 100% technical success rate. There were no procedural complications and only 1 episode of supraventricular arrhythmia requiring therapy. CONCLUSION: Percutaneous closure is associated with a high technical success rate, decreased morbidity compared to surgery, and equal benefits after endothelialization of the device. As the mechanisms involved in PFO are better delineated, clear guidelines can be established for the percutaneous closure and follow-up of PFO.