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A Journal on Heart and Vascular Diseases

Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2014 February;62(1):83-97

language: English

PFO closure: rational, procedure and devices

Reiter R. 1, Bertog S. C. 2, 3, Vaskelyte L. 2, Franke J. 2, Lam S. 2, Gafoor S. 2, Hofmann I. 2, Hornung M. 2, Sievert H. 2

1 The University of Minnesota Medical School Minneapolis, MN, USA;
2 Cardiovascular Center Frankfurt Frankfurt, Germany;
3 Veterans Affairs Medical Center Minneapolis, MN, USA


Patent foramen ovale (PFO) is a common anatomical variant occurring in 20-25% of the population. In most cases, a PFO remains asymptomatic. However it allows for any venous particle such as thrombus, air or vasoactive substances to bypass the lung and enter the arterial circulation. Accordingly, PFO’s have been linked to cryptogenic stroke, migraine and decompression illness. While the number of device closures have been increasing the therapy remains controversial as ‑ until recently ‑ data supporting PFO closure came from non randomized studies only. In this review we will discuss the existing data on PFO closure including results of the three randomized controlled trials comparing device closure with medical therapy in patients with cryptogenic stroke. We will also focus on the implantation technique, the complications and the different devices that are used for this procedure.

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