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Surgical Explantation of an Amplatzer Device for Patent Foramen Ovale Closure in a Patient With Nickel Allergy: A Case Report.
Clin Case Rep
December 2024
Department of Cardiothoracic Surgery HonorHealth Scottsdale Arizona USA.
Patent foramen ovale (PFO) closure using percutaneous devices, such as the Amplatzer occluder, is a common treatment for patients with a history of cryptogenic stroke or transient ischemic attack (TIA). Although generally well-tolerated, some patients may develop adverse reactions to the device materials, particularly in the presence of a nickel allergy. Symptoms can include chest pain, rashes, and migraines, which may necessitate surgical removal of the device.
View Article and Find Full Text PDFRight-to-left shunt detection synchronized contrast transcranial Doppler combined with contrast transthoracic echocardiography: A preliminary study.
World J Radiol
November 2024
Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen 518000, Guangdong Province, China.
Background: Patent foramen ovale (PFO)-related right-to-left shunts (RLSs) have been implicated in cryptogenic stroke and migraine, with larger shunts posing a higher risk. When used individually to detect RLS, contrast transcranial Doppler (cTCD) and contrast transthoracic echocardiography (cTTE) may yield false-negative results. Further, the literature exposes gaps regarding the understanding of the limitations of cTCD and cTTE, presents conflicting recommendations on their exclusive use, and highlights inefficiencies associated with nonsynchronous testing.
View Article and Find Full Text PDFPatent Foramen Ovale (PFO): History, Diagnosis, and Management.
Rev Cardiovasc Med
November 2024
Department of Internal Medicine I, Cardiology, Angiology, Intensive Medical Care, University Hospital Jena, 07747 Jena, Germany.
Article Synopsis
- Current guidelines suggest closing a patent foramen ovale (PFO) in patients aged 16-60 who have had a cryptogenic or cardioembolic stroke and have a high-risk PFO, based on strong evidence.
- The efficacy of PFO closure varies, with studies like the CLOSE and RESPECT trials showing a number needed-to-treat (NNT) of 20 to 44 over five years, while the REDUCE trial indicated an NNT as low as 18 over ten years.
- Although interventional PFO closure is relatively easy to learn, it requires careful execution to reduce complications; research is ongoing for its use in treating migraines, but closures for non-stroke reasons should be evaluated individually.
Sex-Based Differences in Long-Term Outcomes Following Transcatheter Closure of Patent Foramen Ovale for Cryptogenic Stroke.
Circ Cardiovasc Interv
November 2024
Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, ON, Canada (E.F.-U., L.S., M.O., L.B., E.H).
Article Synopsis
- * It included 783 patients, where women's outcomes were compared to men's, revealing no significant differences in stroke recurrence, survival, or new-onset atrial fibrillation over a median follow-up of 14 years.
- * While men had higher rates of pacemaker implantation, the overall results indicate that both sexes benefit similarly from the procedure, highlighting the need for more sex-specific outcome reporting in future research.
Anatomical Significance of the Patent Foramen Ovale by Real-Time 3D TEE in Cryptogenic Stroke and Migraine.
Echocardiography
November 2024
Department of Cardiovascular Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
Background: The transesophageal echocardiogram (TEE) is the standard imaging modality for confirming the presence or absence of patent foramen ovale. PFO is a flap valve depending on the pressure change between the left and right atrium, which can help determine whether to open. 3D-TEE was shown to optimize the visualization of PFO.
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