Management of patients with patent foramen ovale and cryptogenic stroke: A collaborative, multidisciplinary, position paper
Corresponding Author
Christian Pristipino MD
Clinical Research Centre and Cardiovascular Department, San Filippo Neri Hospital, Roma, Italy
Correspondence to: Christian Pristipino, San Filippo Neri Hospital, Via Alessandro Poerio 140, 00152 Rome, Italy. E-mail: [email protected]Search for more papers by this authorGian Paolo Anzola MD
Service of Neurology, S. Orsola Hospital FP, Brescia, Italy
Search for more papers by this authorLuigi Ballerini MD
Women and Children Department, S. Carlo Hospital, Potenza, Italy
Search for more papers by this authorAntonio Bartorelli MD
Interventional Cardiology Area, Monzino Cardiology Centre, Milano, Italy
Search for more papers by this authorMoreno Cecconi MD
Cardiological, Medical and Surgical Sciences Department, University United Hospitals, Ancona, Italy
Search for more papers by this authorMassimo Chessa MD
Pediatric Cardiology and Adult with Congenital Heart Disease Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
Search for more papers by this authorAndrea Donti MD
Pediatric and Developmental Age Cardiology—Bologna University—S. Orsola Malpighi Hospital, Bologna, Italy
Search for more papers by this authorAchille Gaspardone MD
Cardiology Department, Sant'Eugenio Hospital, Roma, Italy
Search for more papers by this authorEustaquio Onorato MD
Cardiology Department, Tor Vergata University, Roma, Italy
Search for more papers by this authorGualtiero Palareti MD
Angiology and Coagulation Disorders Unit—S.Orsola Malpighi Hospital, Bologna, Italy
Search for more papers by this authorSerena Rakar MD
Cardiology Department, Cattinara Hospital, Trieste, Italy
Search for more papers by this authorGianluca Rigatelli MD, PhD
Cardiovascular Diagnosis and Endoluminal Interventions Department, Rovigo General Hospital, Rovigo, Italy
Search for more papers by this authorGennaro Santoro MD
Cardiology and Vessel Department, Careggi Hospital, Firenze, Italy
Search for more papers by this authorDanilo Toni MD
Neurology and Psychiatry Department, Sapienza University, Roma, Italy
Search for more papers by this authorGian Paolo Ussia MD
Invasive Cardiology Unit, Ferrarotto Hospital, Catania University, Catania, Italy
Search for more papers by this authorRoberto Violini MD
Interventional Cardiology Unit, San Camillo Hospital, Roma, Italy
Search for more papers by this authorItalian Society of Invasive Cardiology (SICI-GISE)
Search for more papers by this authorItalian Stroke Association (ISA-AIS)
Search for more papers by this authorItalian Association of Hospital Neurologists, Neuroradiologists, Neurosurgeons (SNO)
Search for more papers by this authorCongenital Heart Disease Study Group of Italian Society Of Cardiology
Search for more papers by this authorItalian Association Of Hospital Cardiologists (ANMCO)
Search for more papers by this authorItalian Society Of Pediatric Cardiology (SICP)
Search for more papers by this authorItalian Society of Cardiovascular Echography (SIEC)
Search for more papers by this authorItalian Society of Hemostasis and Thrombosis (SISET)
Search for more papers by this authorCorresponding Author
Christian Pristipino MD
Clinical Research Centre and Cardiovascular Department, San Filippo Neri Hospital, Roma, Italy
Correspondence to: Christian Pristipino, San Filippo Neri Hospital, Via Alessandro Poerio 140, 00152 Rome, Italy. E-mail: [email protected]Search for more papers by this authorGian Paolo Anzola MD
Service of Neurology, S. Orsola Hospital FP, Brescia, Italy
Search for more papers by this authorLuigi Ballerini MD
Women and Children Department, S. Carlo Hospital, Potenza, Italy
Search for more papers by this authorAntonio Bartorelli MD
Interventional Cardiology Area, Monzino Cardiology Centre, Milano, Italy
Search for more papers by this authorMoreno Cecconi MD
Cardiological, Medical and Surgical Sciences Department, University United Hospitals, Ancona, Italy
Search for more papers by this authorMassimo Chessa MD
Pediatric Cardiology and Adult with Congenital Heart Disease Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
Search for more papers by this authorAndrea Donti MD
Pediatric and Developmental Age Cardiology—Bologna University—S. Orsola Malpighi Hospital, Bologna, Italy
Search for more papers by this authorAchille Gaspardone MD
Cardiology Department, Sant'Eugenio Hospital, Roma, Italy
Search for more papers by this authorEustaquio Onorato MD
Cardiology Department, Tor Vergata University, Roma, Italy
Search for more papers by this authorGualtiero Palareti MD
Angiology and Coagulation Disorders Unit—S.Orsola Malpighi Hospital, Bologna, Italy
Search for more papers by this authorSerena Rakar MD
Cardiology Department, Cattinara Hospital, Trieste, Italy
Search for more papers by this authorGianluca Rigatelli MD, PhD
Cardiovascular Diagnosis and Endoluminal Interventions Department, Rovigo General Hospital, Rovigo, Italy
Search for more papers by this authorGennaro Santoro MD
Cardiology and Vessel Department, Careggi Hospital, Firenze, Italy
Search for more papers by this authorDanilo Toni MD
Neurology and Psychiatry Department, Sapienza University, Roma, Italy
Search for more papers by this authorGian Paolo Ussia MD
Invasive Cardiology Unit, Ferrarotto Hospital, Catania University, Catania, Italy
Search for more papers by this authorRoberto Violini MD
Interventional Cardiology Unit, San Camillo Hospital, Roma, Italy
Search for more papers by this authorItalian Society of Invasive Cardiology (SICI-GISE)
Search for more papers by this authorItalian Stroke Association (ISA-AIS)
Search for more papers by this authorItalian Association of Hospital Neurologists, Neuroradiologists, Neurosurgeons (SNO)
Search for more papers by this authorCongenital Heart Disease Study Group of Italian Society Of Cardiology
Search for more papers by this authorItalian Association Of Hospital Cardiologists (ANMCO)
Search for more papers by this authorItalian Society Of Pediatric Cardiology (SICP)
Search for more papers by this authorItalian Society of Cardiovascular Echography (SIEC)
Search for more papers by this authorItalian Society of Hemostasis and Thrombosis (SISET)
Search for more papers by this authorPosition statement by the Italian Society of Invasive Cardiology (SICI-GISE); Italian Stroke Association (ISA-AIS); Italian Association of Hospital Neurologists, Neuroradiologists, Neurosurgeons (SNO); Congenital Heart Disease Study Group of Italian Society Of Cardiology; Italian Association Of Hospital Cardiologists (ANMCO); Italian Society Of Pediatric Cardiology (SICP); Italian Society of Cardiovascular Echography (SIEC); Italian Society of Hemostasis and Thrombosis (SISET)
Conflict of interest: Massimo Chessa has a proctorship contract with AGA medical, St Jude Medical, Gore, and Cardia. Andrea Donti has a proctorship contract with AGA medical. Achille Gaspardone has a proctorship contract with NMT Medical, Boston, MA (BioSTAR device) and is investigator of BRAVO (A PROSPECTIVE, MULTI-CENTRE, REGISTRY FOR EVALUATION OF THE BioSTAR® SEPTAL REPAIR IMPLANT FOR THE CLOSURE OF PATENT FORAMEN OVALE) Eustaquio Onorato is the principle investigator of INTUIRE (IN-TUNNEL PFO CLOSURE ITALIAN REGISTRY) concerning Coherex FlatStent EF (Coherex Medical) and has proctorship contract with Occlutech Italy. Gianluca Rigatelli has a consultant/proctor contract with St Jude Medical Italy Gennaro Santoro has a proctorship contract with AGA medical. Vittorio Ambrosini received honoraria for being a guest speaker in Occlutech sponsored symposia.
Abstract
Objectives: To organize a common approach on the management of patent foramen ovale (PFO) and cryptogenic stroke that may be shared by different specialists. Background: The management of PFO related to cryptogenic stroke is controversial, despite an increase in interventional closure procedures. Methods: A consensus statement was developed by approaching Italian national cardiological, neurological, and hematological scientific societies. Task force members were identified by the president and/or the boards of each relevant scientific society or working group, as appropriate. Drafts were outlined by specific task force working groups. To obtain a widespread consensus, these drafts were merged and distributed to the scientific societies for local evaluation and revision by as many experts as possible. The ensuing final draft, merging all the revisions, was reviewed by the task force and finally approved by scientific societies. Results: Definitions of transient ischemic attack and both symptomatic and asymptomatic cryptogenic strokes were specified. A diagnostic workout was identified for patients with candidate event(s) and patient foramen ovale to define the probable pathogenesis of clinical events and to describe individual PFO characteristics. Further recommendations were provided regarding medical and interventional therapy considering individual risk factors of recurrence. Finally, follow-up evaluation was appraised. Conclusions: Available data provided the basis for a shared approach to management of cryptogenic ischemic cerebral events and PFO among different Italian scientific societies. Wider international initiatives on the topic are awaited. © 2013 Wiley Periodicals, Inc.
REFERENCES
- 1Adams HPJr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE3rd. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993; 24; 35–41.
- 2Sacco RL, Ellenberg JH, Mohr JP, Tatemichi TK, Hier DB, Price TR, Wolf PA. Infarcts of undetermined cause: The NINCDS Stroke Data Bank. Ann Neurol 1989; 25: 382–390.
- 3Cohnheim J. Thrombose und Embolie: Vorlesung über Allgemeinepathologie. Berlin: Hirschwald; 1877, p 134.
- 4Handke M, Harloff A, Olschewski M, Hetzel A, Geibel A. Patent foramen ovale and cryptogenic stroke in older patients. N Engl J Med 2007; 29: 2262–2268.
- 5Webster MW, Chancellor AM, Smith HJ, Swift DL, Sharpe DN, Bass NM, Glasgow GL. Patent foramen ovale in young stroke patients. Lancet 1988; 2: 11–12.
- 6Myers PO, Fassa AA, Panos A, Licker M, Bounameaux H, Zender HO, Kalangos A.. Life-threatening pulmonary embolism associated with a thrombus straddling a patent foramen ovale: report of a case. J Card Surg. 2008; 23: 376–378.
- 7Penther P. Patent foramen ovale: an anatomical study. Apropos of 500 consecutive autopsies. Arch Mal Coeur Vaiss. 1994; 87: 15–21.
- 8Overell JR, Born I, Lees KR. Interatrial septal abnormalities and stroke: A meta-analysis of case-control studies. Neurology 2000; 55: 1172–1179.
- 9Messé SR, Cucchiara B, Luciano J, Kasner SE. FOP management: Neurologists vs cardiologists. Neurology. 2005; 65: 172–173.
- 10Meissner I, Khandheria BK, Heit JA, Petty GW, Sheps SG, Schwartz GL, Whisnant JP, Wiebers DO, Covalt JL, Petterson TM, Christianson TJ, Agmon Y. Patent foramen ovale: innocent or guilty? Evidence from a prospective population-based study. J Am Coll Cardiol. 2006; 47: 440–445.
- 11Handke M, Harloff A, Olschewski M, Hetzel A, Geibel A. Patent foramen ovale and cryptogenic stroke in older patients. N Engl J Med. 2007; 357: 2262–2268.
- 12Alsheikh-Ali AA, Thaler DE, Kent DM. Patent foramen ovale in cryptogenic stroke: Incidental or pathogenic? Stroke 2009; 40: 2349–2355.
- 13Di Tullio MR, Sacco RL, Sciacca RR, Jin Z, Homma S. Patent foramen ovale and the risk of ischemic stroke in a multiethnic population. J Am Coll Cardiol. 2007; 49: 797–802.
- 14 Stroke: Italian guidelines for the prevention and treatment. Executive summary and recommenadtions. (Ictus cerebrale: Linee guida italiane di prevenzione e trattamento. Sintesi e raccomandazioni). SPREAD Live. Available at: www.spread.it, 2010 (accessed on March 11, 2011).
- 15 The European Stroke Organisation (ESO) Executive Committee and the ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cardiovasc Dis 2008; 25: 457–507
- 16Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, Halperin JL, Johnston SC, Katzan I, Kernan WN, Mitchell PH, Ovbiagele B, Palesch YY, Sacco RL, Schwamm LH, Wassertheil-Smoller S, Turan TN, Wentworth D; American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research.; American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for healthcare professionals from the American heart association/American stroke association. Stroke 2011; 42: 227–276.
- 17 2009 General directory of procedures performed in Italian laboratories. (Elenco generale delle procedure effettuate nei Laboratori italiani nel 2009). Il giornale italiano di Cardiologia invasiva. Available at: http://www.ilgiornale.gise.it/view_articoli.php?cartella=02&base_path=2_2010_suppl&da=19&a=37 (accessed March 11, 2011).
- 18Pristipino C, Toni D, Violini R, Corsi FM, Pozzessere C, Gaspardone A, Iani C, Trani C, Profice P, Greco C, Sardella G, Berni A, Cao M, Serdoz R, Peresson M, Pucci E, Prati F, Salerno A, Martuscelli E, Diomedi M, Mangieri E, Mancini G, Ballerini L, Altavista MC. Regional consensus document on the indications for the percutaneous closure of patent foramen ovale in the presence of cryptogenic stroke. (Documento di consenso regionale sulle indicazioni alla chiusura percutanea del forame ovale pervio in presenza di ictus criptogenico). G Ital Cardiol Invasiva; 2010;1: 21–31.
- 19Pinto Slottow TL, Steinberg DH; Waksman R. Overview of the 2007 food and drug administration circulatory system devices panel meeting on patent foramen ovale closure devices. Circulation 2007; 116; 677–682.
- 20 Stroke trials registry. The Internet Stroke Center. Available at: http://www.strokecenter.org/trials/browse.aspx?status=4. Modified on March 12, 2010 (accessed on March 11, 2011).
- 21Furlan AJ, Reisman M, Massaro J, Mauri L, Adams H, Albers GW, Felberg R, Herrmann H, Kar S, Landzberg M, Raizner A, Wechsler L for the CLOSURE I investigators. Closure or medical therapy for cryptogenic stroke with patent foramen ovale. New Engl J Med 2012; 366: 991–999.
- 22Wessels T, Röttger C, Jauss M, Kaps M, Traupe H, Stolz E. Identification of embolic stroke patterns by diffusion-weighted MRI in clinically defined lacunar stroke syndromes. Stroke 2005; 36: 757–761.
- 23Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, Feldmann E, Hatsukami TS, Higashida RT, Johnston SC, Kidwell CS, Lutsep HL, Miller E, Sacco RL; American Heart Association; American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Interdisciplinary Council on Peripheral Vascular Disease. Definition and evaluation of transient ischemic attack: A scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. Stroke 2009; 40: 2276–2293.
- 24 Toni D, Sacco RL, Brainin M, Mohr JP. Classification of ischemic stroke. In: Mohr JP, Wolf PA, Grotta JC, Moskowitz MA, Mayberg MR, Von Kumme R editors. Stroke: Pathophysiology, Diagnosis and Management, 5th ed., Elsevier; Philadelphia, PA, USA, 2011. Chapter 22, pp.293–206.
- 25Johnston SC, Rothwell PM, Nguyen-Huynh MN, Giles MF, Elkins JS, Bernstein AL, et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 2007; 369: 283–292
- 26Ballerini L, Cifarelli A, Ammirati A, Gimigliano F. Patent foramen ovale and cryptogenic stroke, A critical review. J Cardiovasc Med 2007; 8: 34–38.
- 27Testai FD, Gorelick PB. Inherited metabolic disorders and stroke part 1: Fabry disease and mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes. Arch Neurol 2010; 67: 19–24.
- 28Chabriat H, Joutel A, Dichgans M, Tournier-Lasserve E, Bousser MG. CADASIL. Lancet Neurol 2009; 8: 643–653.
- 29Testai FD, Gorelick PB. Inherited metabolic disorders and stroke part 2: Homocystinuria, organic acidurias, and urea cycle disorders Arch Neurol 2010; 67: 148–153.
- 30Roder C, Nayak NR, Khan N, Tatagiba M, Inoue I, Krischek B. Genetics of moyamoya disease. J Hum Genet 2010; 55: 711–716.
- 31Gerraty RP, Parsons MW, Barber PA, Darby DG, Desmond PM, Tress BM, et al. Examining the lacunar hypothesis with diffusion and perfusion magnetic resonance imaging. Stroke 2002; 33: 2019–2024.
- 32Papa M, Gaspardone A, Fragasso G, Ajello S, Gioffrè G, Iamele M, Iani C, Margonato A. Usefulness of transcatheter patent foramen ovale closure in migraineurs with moderate to large right-to-left shunt and instrumental evidence of cerebrovascular damage. Am J Cardiol 2009; 104: 434–439.
- 33Jauss M, Wessels T, Trittmacher S, Allendorfer J, Kaps M. Embolic lesion pattern in stroke patients with patent foramen ovale compared with patients lacking an embolic source. Stroke 2006; 37: 2159–2161.
- 34Feurer R, Sadikovic S, Esposito L, Schwarze J, Bockelbrink A, Hemmer B, et al. Lesion patterns in patients with cryptogenic stroke with and without right-to-left-shunt. Eur J Neurol 2009; 16: 1077–1082.
- 35Clergeau MR, Hamon M, Morello R, Saloux E, Viader F, Hamon M. Silent cerebral infarcts in patients with pulmonary embolism and a patent foramen ovale. a prospective diffusion-weighted MRI study. Stroke 2009; 40: 3758–3762.
- 36Stöllberger C, Finsterer J. Detection of paroxysmal atrial fibrillation and patent foramen ovale in cryptogenic stroke. Eur J Neurol. 2009; 16: 160–161.
- 37Tanne D, Dolhaberriague L, Schultz LR, SalowichPalm L, Sawaya KL, Levine SR. Anticardiolipin antibodies and their associations with cerebrovascular risk factors. Neurology 1999; 52: 1368–1373.
- 38Rajamani K, Chaturvedi S, Jin Z, Homma S, Brey RL, Tilley BC, Sacco RL, Thompson JL, Mohr JP, Levine SR; PICSS-APASS Investigators. Patent foramen ovale, cardiac valve thickening, and antiphospholipid antibodies as risk factors for subsequent vascular events: the PICSS-APASS study. Stroke 2009; 40: 2337–2342.
- 39González-Alujas T, Evangelista A, Santamarina E, Rubiera M, Gómez-Bosch Z, Rodríguez-Palomares JF, Avegliano G, Molina C, Alvarez-Sabín J, García-Dorado D. Diagnosis and quantification of patent foramen ovale. Which is the reference technique? Simultaneous study with transcranial Doppler, transthoracic and transesophageal echocardiography. Rev Esp Cardiol. 2011; 64: 133–139.
- 40Clarke NR, Timperley J, Kelion AD, Banning AP. Transthoracic echocardiography using second harmonic imaging with Valsalva maneuver for the detection of right to left shunts. Eur J Echocardiogr 2004; 5: 176–181.
- 41Madala D, Zaroff JG, Hourigan L, Foster E. Harmonic imaging improves sensitivity at the expense of specificity in the detection of patent foramen ovale. Echocardiography 2004; 21: 33–36.
- 42Anzola GP, Morandi E, Casilli F, Onorato E. Different degrees of right-to-left shunting predict migraine and stroke: data from 420 patients. Neurology 2006; 67: 919–920
- 43Daniëls C, Weytjens C, Cosyns B, Schoors D, De Sutter J, Paelinck B, Muyldermans L, Van Camp G. Second harmonic transthoracic echocardiography: the new reference screening method for the detection of patent foramen ovale. Eur J Echocardiogr. 2004; 5: 449–452.
- 44Giardina A, Stefanini G, Gioffrè G, Iamele M, Gaspardone A. The Valsalva maneuver in the diagnosis of patent foramen ovale. G Ital Cardiol 2010; 11: 478–480.
- 45Mügge A, Daniel WG, Angermann C, Spes C, Khandheria BK, Kronzon I, Freedberg RS; Keren A; Dennig K; Engberding R, Sutherland GR; Vered Z; Erbel R; Visser CA; Lindert O, Hausmann D, Wenzlaff P. Atrial septal aneurysm in adult patients. A multicenter study using transthoracic and transesophageal echocardiography. Circulation 1995; 91: 2785–2792.
- 46Anzola GP, Zavarise P. Morandi E, Rozzini L, Parrinello G. Transcranial Doppler and risk of recurrence in patients with stroke and patent foramen ovale. Eur J Neurol 2003; 10: 129–135.
- 47Almekhlafi MA, Wilton SB, Rabi DM, Ghali WA, Lorenzetti DL, Hill MD. Recurrent cerebral ischemia in medically treated patent foramen ovale: a meta-analysis. Neurology 2009; 73: 89–97.
- 48Homma S, Sacco RL, Di Tullio MR, Sciacca RR, Mohr JP; PFO in Cryptogenic Stroke Study (PICSS) Investigators. Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study. Circulation 2002; 105: 2625–2631.
- 49Mohr JP, Thompson JLP, Lazar RM, Levin B, Sacco RL, Furie KL, Kistler JP, Albers GW, Pettigrew LC, Adams HPJr, Jackson CM, Pullicino P; Warfarin-Aspirin Recurrent Stroke Study Group. A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. N Engl J Med 2001; 345: 1444–1451.
- 50Halkes PH, van Gijn J, Kappelle LJ, Koudstaal PJ, Algra A. Medium intensity oral anticoagulants versus aspirin after cerebral ischaemia of arterial origin (ESPRIT): A randomised controlled trial. Lancet Neurol 2007; 6: 115–124.
- 51Messe SR, Silverman IE, Kizer JR, Homma S, Zahn C, Gronseth G, Kasner SE; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: Recurrent stroke with patent foramen ovale and atrial septal aneurysm—Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2004; 62: 1042–1050.
- 52Pezzini A, Grassi M, Zotto ED, Giossi A, Volonghi I, Costa P, Grau A, Magoni M, Padovani A, Lichy C. Do common prothrombotic mutations influence the risk of cerebral ischaemia in patients with patent foramen ovale? Systematic review and meta-analysis. Thromb Haemost 2009; 101: 813–817.
- 53Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and thrombolytic therapy for ischemic stroke: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133: 630S–669S.
- 54Bridges ND, Hellenbrand W, Latson L, Filiano J, Newburger JW, Lock JE. Transcatheter closure of patent foramen ovale after presumed paradoxical embolism. Circulation 1992; 86: 1902–1908.
- 55Homma S, Sacco RL. Patent foramen ovale and stroke. Circulation 2005; 112: 1063–1072.
- 56Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G, Coste J; Patent Foramen Ovale and Atrial Septal Aneurysm Study Group. Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm or both. N Engl J Med 2001; 345: 1740–1746.
- 57Anzola GP, Giusti del Giardino L, Piras MP. Patent foramen ovale (PFO) and cryptogenic stroke. J Thromb Haemost 2010; 8: 1675–1677.
- 58Goel SS, Tuzcu EM, Shishehbor MH, De Oliveira EI, Borek PP, Krasuki RA, Rodriguez LL, Kapadia SR. Morpholgy of the patent foramen ovale in asymptomatic versus symptomatic (stroke or transient ischemic attack) patients. Am J Cardiol 2009; 103: 124–129.
- 59Serena J, Marti-Fabregas J, Santamarina E, Rodriguez JJ, Perez-Ayuso MJ, Masjuan J, Segura T, Gállego J, Dávalos A; CODICIA, Right-to-Left Shunt in Cryptogenic Stroke Study; Stroke Project of the Cerebrovascular Diseases Study Group, Spanish Society of Neurology. CODICIA, Right to left Shunt in Cryptogenic Stroke Study; Stroke Project of the Cerebrovascular Diseases Study Group, Spanish Society of Neurology. Stroke 2008; 39: 3131–3136.
- 60Khairy P, O'Donnell CP, Landzberg MJ. Transcatheter closure versus medical therapy of patent foramen ovale and presumed paradoxical thromboemboli: A systematic review. Ann Intern Med 2003; 139: 753–760.
- 61Yared K, Baggish AL, Solis J, Durst R, Passeri JJ, Palacios IF, Picard MH. Echocardiographic assessment of percutaneous patent foramen ovale and atrial septal defect closure complications. Circ Cardiovasc Imaging 2009; 2; 141–149.
- 62Onorato E, Melzi G, Casilli F, Pedon L, Rigatelli G, Carrozza A, Maiolino P, Zanchetta M, Morandi E, Angeli S, Anzola GP. Patent foramen ovale with paradoxical embolism: Mid-term results of transcatheter closure in 256 patients. J Interv Cardiol 2003; 16: 11–18.
10.1046/j.1540-8183.2003.08002.x Google Scholar
- 63Kiblawi FM, Sommer RJ, Levchuck SG. Transcatheter closure of patent foramen ovale in older adults. Catheter Cardiovasc Interv 2006; 68: 136–142.
- 64Spies C, Khandelwal A, Timmermanns I, Schrader R. Incidence of atrial fibrillation following transcatheter closure of atrial septal defects in adults. Am J Cardiol 2008; 102: 902–906.
- 65Burow A, Schwerzmann M, Wallmann D, Tanner H, Sakata T, Windecker S, Meier B, Delacrétaz E. Atrial fibrillation following device closure of patent foramen ovale. Cardiology 2008; 111: 47–50.
- 66Wagdi P. Incidence and predictors of atrial fibrillation following transcatheter closure of interatrial septal communications using contemporary devices Clin Res Cardiol 2010; 99: 507–510.
- 67Staubach S, Steinberg DH, Zimmermann W, Wawra N, Wilson N, Wunderlich N, Sievert H. New onset atrial fibrillation after patent foramen ovale closure. Catheter Cardiovasc Interv 2009; 74: 889–895.
- 68Krumsdorf U, Ostermayer S, Billinger K, Trepels T, Zadan E, Horvath K, et al. Incidence and clinical course of thrombus formation on atrial septal defect and patient foramen ovale closure devices in 1,000 consecutive patients. J Am Coll Cardiol 2004; 43: 302–309.
- 69Ho SY, MacCarthy KP, Rigby ML. Morphological features pertinent to interventional closure of patent oval foramen. J Interv Cardiol 2003; 16: 33–38.
- 70Amin Z, Hijazi ZM, Bass JL, Cheatham JP, Hellenbrand WE, Kleinman CS. Erosion of Amplatzer septal occluder device after closure of secundum atrial septal defects: Review of registry of complications and recommendations to minimize future risk. Catheter Cardiovasc Interv. 2004; 63: 496–502.
- 71Slavin L, Tobis JM, Rangarajan K, Dao C, Krivokapich J, Liebeskind DS. Five-year experience with percutaneous closure of patent foramen ovale. Am J Cardiol 2007; 99: 1316–1320.
- 72Alameddine F, Block PC. Transcatheter patent foramen ovale closure for secondary prevention of paradoxical embolic events: acute results from the FORECAST registry. Catheter Cardiovasc Interv 2004; 62: 512–516.
- 73Misra M, Sadiq A, Namboodiri N, Karunakaran J. The ‘aortic rim’ recount: Embolization of interatrial septal occluder into the main pulmonary artery bifurcation after atrial septal defect closure. Interact Cardiovasc Thorac Surg. 2007; 6: 384–386.
- 74Beitzke A, Schuchlenz H, Gamillscheg A, Stein JI, Wendelin G. Catheter closure of the persistent foramen ovale: mid-term results in 162 patients. J Interv Cardiol. 2001; 14: 223–229.
- 75Saguner AM, Wahl A, Praz F, de Marchi SF, Mattle HP, Cook S, Windecker S, Meier B. Figulla PFO occluder versus Amplatzer PFO occluder for percutaneous closure of patent foramen ovale. Catheter Cardiovasc Interv. 2010; 77: 709–714.
- 76Rabkin DG, Whitehead KJ, Michaels AD, Powell DL, Karwande SV. Unusual presentation of nickel allergy requiring explanation of an Amplatzer atrial septal occluder device. Clin Cardiol 2009; 8: E55–E57.
10.1002/clc.20427 Google Scholar
- 77Mahadevan VS, Horlick EM, Benson LN, McLaughlin PR. Transcatheter closure of aortic sinus to left atrial fistula caused by erosion of amplatzer septal occluder. Cathet Cardiovasc Interv 2006; 68: 749–753.
- 78Rigatelli G, Dell'Avvocata F, Ronco F, Giordan M, Cardaioli P. Patent oval foramen transcatheter closure: Results of a strategy based on tailoring the device to the specific patient's anatomy. Cardiol Young 2010; 20: 144–149.
- 79Wahl A, Praz F, Stinimann J, Windecker S, Seiler C, Nedeltchev K, Mattle HP, Meir B. Safety and feasibility of percutaneous closure of patent foramen ovale without intra-procedural echocardiography in 825 patients. Swiss Med Wkly 2008; 138: 567–572.
- 80Pelliccia F, Cianfrocca C, Pasceri V, Granatelli A, Speciale G, Roncella A, Turturo M, Richichi G, Pristipino C. Transcathether occlusion of interatrial communications: postprocedural transoesophageal echocardiography allows timely detection and treatment of intracardiac thrombus formation. Eur J Echocardiogr 2009; 10: 439–441.
- 81Zanchetta M, Rigatelli G, Pedon L, Zennaro M, Carrozza A, Onorato E, Maiolino P. Transcatheter atrial septal defect closure assisted by intracardiac echocardiography: 3-year follow-up. J Interv Cardiol 2004; 17: 95–98.
