5,711 results match your criteria Patent Foramen Ovale


Cerebral vasomotor reactivity in migraine: effect of patent foramen ovale and aerogenic microembolism.

Neurol Res 2020 Jun 4:1-10. Epub 2020 Jun 4.

Department of Neurology, Hacettepe University Hospitals , Ankara, Turkey.

Objective: The first data on the effect of presence of patent foramen ovale (PFO) with high-volume right-to-left shunt (RLS) on cerebral vasomotor reactivity (CVMR) in migraineurs are herein presented. In addition, the immediate effect of air microbubbles on CVMR has been determined.

Methods: Breath-holding index (BHI) and percent velocity decrease during hyperventilation (HPV) tests were performed before and after agitated saline injections in bilateral middle and posterior cerebral arteries (MCA and PCA) in 38 migraineurs (19 with aura) and 18 control subjects. Read More

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http://dx.doi.org/10.1080/01616412.2020.1775015DOI Listing

Structural heart intervention for prevention of embolic and hemorrhagic stroke: The new field of neurocardiology.

J Cardiol 2020 May 29. Epub 2020 May 29.

Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.

Cardiogenic stroke (CS), characteristic causes of which include atrial fibrillation (AF) and right-to-left shunting due to a patent foramen ovale (PFO), has a well-known tendency to be associated with a more extensive ischemic area. This may result in severe neurological damage, and require strict life-long antithrombotic therapy. However, the fact that some patients have problems complying with the requirement for extended oral antithrombotic treatment has motivated the development of alternative approaches for stroke prevention. Read More

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http://dx.doi.org/10.1016/j.jjcc.2020.04.007DOI Listing

Patent Foramen Ovale as a Rare Focus of Origination of Atrial Tachycardia.

J Innov Card Rhythm Manag 2019 Apr 15;10(4):3612-3616. Epub 2019 Apr 15.

Department of Cardiology, Crozer-Chester Medical Center, Upland, PA, USA.

Supraventricular tachycardia refers to a group of arrhythmias whose mechanism involves tissues from the His bundle or above. Repetitive focal atrial tachycardia (AT) (FAT) accounts for less than 10% of supraventricular tachycardia cases. FAT originating from the patent foramen ovale (PFO) has not been well-described and is a rarely reported phenomenon to date. Read More

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http://dx.doi.org/10.19102/icrm.2019.100405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252791PMC

Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation.

J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620925575

University of Washington, Seattle, WA, USA.

Platypnea orthodeoxia syndrome (POS) occurs when an upright position results in acute-onset hypoxemia and is relieved with recumbency. POS can be due to intracardiac shunting, intrapulmonary shunting, ventilation-perfusion mismatch, or a combination of these. We report a case of POS that developed 3 days post liver transplantation as a result of new-onset right to left shunting across a patent foramen ovale. Read More

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http://dx.doi.org/10.1177/2324709620925575DOI Listing

Aortic root dilatation in PFO-related cryptogenic stroke: A propensity score-matched analysis.

Echocardiography 2020 May 25. Epub 2020 May 25.

Department of Intensive Cardiac Care Unit, Amiens University Hospital, Amiens, France.

Background: Dilatation of the ascending aorta has an important role in the anatomical conformation of interatrial septum (IAS) especially when a patent foramen ovale (PFO) is present. The aim of the study was to investigate the relationship between ascending aortic dilation and PFO-related cryptogenic stroke in a cohort of cryptogenic strokes.

Methods: It is a retrospective, single-center echocardiographic study assessing aortic root dilatation in 315 consecutive patients with cryptogenic stroke between January 2011 and January 2019. Read More

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http://dx.doi.org/10.1111/echo.14711DOI Listing

[Utility of transesophageal echocardiography for etiologic diagnosis of centrum ovale infarcts].

Rinsho Shinkeigaku 2020 May 19. Epub 2020 May 19.

Department of Neurology, Kyoto 2nd Red Cross Hospital.

A small centrum ovale infarct in the territory of the white matter medullary artery can be caused not only by embolism but also small-vessel disease. In our study, thorough screening for emboligenic diseases was performed, including the modality of transesophageal echocardiography (TEE), in patients with an acute, isolated, small (less than 1.5 cm) infarct in the centrum ovale. Read More

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http://dx.doi.org/10.5692/clinicalneurol.60.cn-001388DOI Listing

Large Left Atrial Thrombus on Amplatzer Septal Occluder Secondary to Medication Nonadherence.

Am J Med Case Rep 2020 22;8(7):197-201. Epub 2020 Apr 22.

Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States-11203.

Patent foramen ovale (PFO) is a common clinical entity that is encountered in 20-34% of the general population. In most individuals, this anatomical variation is asymptomatic and goes undetected throughout their lives or is only incidentally discovered on cardiac investigations. In situations when the conduit is large enough and when the right atrial pressure exceeds the left atrial pressure, right to left interatrial flow may occur in these individuals. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236968PMC

Warning regarding thrombosis-in-transit across the patent foramen ovale associated with pulmonary embolism: ultrasonographic imaging analysis.

Acute Med Surg 2020 Jan-Dec;7(1):e505. Epub 2020 Apr 15.

Department of Cardiovascular Surgery Tokyo Medical University Tokyo Japan.

Contrast-enhanced CT is useful for diagnosing Pulmonaly embolism (PE) but not for foramen ovale thrombi. Therefore, cardiac ultrasonographic observation of the atrial septum is important to avoid overlooking foramen ovale thrombi. Read More

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http://dx.doi.org/10.1002/ams2.505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231561PMC

Deep Vein Thrombosis and Pulmonary Embolism Among Patients With a Cryptogenic Stroke Linked to Patent Foramen Ovale-A Review of the Literature.

Front Neurol 2020 5;11:336. Epub 2020 May 5.

Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.

Venous thromboembolism (VTE) can occur simultaneously with a cryptogenic stroke (CS) linked to patent foramen ovale (PFO), given paradox thromboembolism as potential stroke cause. However, little is known on the frequency of concomitant VTE and CS. We aimed to review the literature on the frequency of VTE in patients with CS linked to PFO (primary aim) and of ischemic stroke (IS) among patients with pulmonary embolism (PE) (secondary aim). Read More

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http://dx.doi.org/10.3389/fneur.2020.00336DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214694PMC

Recurrent cerebrovascular events in patients after percutaneous closure of patent foramen ovale.

J Stroke Cerebrovasc Dis 2020 May 16:104860. Epub 2020 May 16.

Centrum for Adults with Grown-Up Congenital Heart Disease (GUCH), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. Electronic address:

Background: Recent published trials have shown the efficacy of transcatheter closure of patent foramen ovale (PFO) for preventing recurrent cryptogenic cerebrovascular events. However, the risk of recurrent cerebrovascular events (rCVEs) is up to 5.7%, and the etiology is unclear. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104860DOI Listing

Residual Shunt After Patent Foramen Ovale Closure and Long-Term Stroke Recurrence: A Prospective Cohort Study.

Ann Intern Med 2020 Jun 12;172(11):717-725. Epub 2020 May 12.

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).

Background: Residual shunt is observed in up to 25% of patients after patent foramen ovale (PFO) closure, but its long-term influence on stroke recurrence currently is unknown.

Objective: To investigate the association of residual shunt after PFO closure with the incidence of recurrent stroke and transient ischemic attack (TIA).

Design: Prospective cohort study comparing stroke or TIA recurrence in patients with and without residual shunt after PFO closure. Read More

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http://dx.doi.org/10.7326/M19-3583DOI Listing

Epidemiology of Patent Foramen Ovale in General Population and in Stroke Patients: A Narrative Review.

Front Neurol 2020 28;11:281. Epub 2020 Apr 28.

Second Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Percutaneous closure of patent foramen ovale (PFO) in selected patients with cryptogenic cerebrovascular ischemic events (CEs) decreases the risk of recurrent stroke; however, optimal patient selection criteria are still under investigation. Candidates for PFO closure are usually selected from the pool of CE patients with a high risk of Paradoxical Embolism (RoPE) score. The RoPE score calculates the probability that PFO is causally related to stroke, based on PFO prevalence in patients with CE compared with that in healthy subjects. Read More

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http://dx.doi.org/10.3389/fneur.2020.00281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198765PMC

Acromicric dysplasia with stiff skin syndrome-like severe cutaneous presentation in an 8-year-old boy with a missense FBN1 mutation: Case report and literature review.

Mol Genet Genomic Med 2020 May 14:e1282. Epub 2020 May 14.

Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Acromicric dysplasia is a rare heritable short-stature syndrome with joint stiffness and varying degrees of cutaneous hardness. Stiff skin syndrome is a rare connective tissue disorder characterized by diffusely thick and hard skin from the time of birth. Heterozygous point mutations in the FBN1 have been proposed as the predominant cause of both diseases. Read More

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http://dx.doi.org/10.1002/mgg3.1282DOI Listing

Surgical vs. drug therapy in patients with patent foramen ovale and cryptogenic stroke.

Herz 2020 May 11. Epub 2020 May 11.

Cardiac Electrophysiological Center, Mianyang Central Hospital, 621000, Mianyang, Sichuan, China.

Objective: This study aimed to investigate the effectiveness of risk scoring for predicting stroke recurrence after percutaneous patent foramen ovale (PFO) closure or medication therapy in patients with PFO and a history of cryptogenic stroke.

Methods: This study included 559 patients with PFO and cryptogenic stroke who were treated in our hospital from January 2013 to January 2018 and were followed up for 15-72 months. After calculating the risk scores for stroke recurrence, we randomly divided the patients into two groups (ratio, 1:1): Patients in one group underwent PFO closure and those in the other received drug therapy. Read More

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http://dx.doi.org/10.1007/s00059-020-04921-3DOI Listing

[Is there a relationship between white matter lesions associated with migraine and patent foramen ovale? Analysis of a series of patients with chronic migraine].

Rev Neurol 2020 May;70(10):372-378

Hospital Universitario Central de Asturias, Oviedo, España.

Introduction: White matter lesions are more prevalent in migraine patients than in the general population, especially those with a high frequency of attacks. A patent foramen ovale has been described as a possible link between migraine and white matter lesions.

Aim: To determine the existence of a possible relationship between a patent foramen ovale and white matter lesions in a series of patients with chronic migraine. Read More

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http://dx.doi.org/10.33588/rn.7010.2019435DOI Listing

[Platypnea-orthodeoxia syndrome: a neglected cause of dyspnea?]

Lakartidningen 2020 May 6;117. Epub 2020 May 6.

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A 68-year-old woman presented with progressive and severe effort-related dyspnea. Her history included an ischemic stroke at age 43. Routine exams were normal. Read More

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Clinical RoPE (cRoPE) score predicts patent foramen ovale detection among stroke patients: a multicenter observational study.

Neurol Sci 2020 May 9. Epub 2020 May 9.

Neurology Unit, G. Jazzolino Hospital, Vibo Valentia, Italy.

Backgroud: The role of patent foramen ovale (PFO) in cryptogenic stroke (CS) is debated. Tools to predict PFO occurrence and attributable fraction are needed to guide cost-effective diagnostics and treatment. Risk of Paradoxical Embolism (RoPE) score relies on neuroimaging findings, which might be inconclusive in up to 30% of cases. Read More

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http://dx.doi.org/10.1007/s10072-020-04386-6DOI Listing
May 2020
1.495 Impact Factor

Acute cerebral infarction with acute myocardial infarction due to patent foramen ovale: A case report.

Medicine (Baltimore) 2020 May;99(19):e20054

Department of Hepatobiliary Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, P. R. China.

Rationale: Patent foramen ovale (PFO) is not considered to be the main cause of stroke and is classified as the infarction of undetermined cause. The relationship between PFO and cerebral embolism is still unclear and cerebral embolism accompanied with coronary artery embolization in PFO patient is rare. In this case, we reported a patient with PFO suffered acute cerebral and myocardial infarction simultaneously, and analyzed the source of emboli and potential pathogenesis. Read More

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http://dx.doi.org/10.1097/MD.0000000000020054DOI Listing

Cannula migration through an undiagnosed patent foramen ovale and embolic cerebrovascular accident in a patient with femoral venoarterial extracorporeal membrane oxygenation.

J Card Surg 2020 May 7. Epub 2020 May 7.

Division of Cardiothoracic Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky.

We present a case report of a patient with a pulmonary embolus placed on venoarterial extracorporeal membrane oxygenation who developed venous cannula migration through an undiagnosed patent foramen ovale causing an ischemic stroke due to a thrombus and requiring thrombectomy and device closure of the atrial defect. Read More

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http://dx.doi.org/10.1111/jocs.14618DOI Listing

Risk Management: "High-Risk" PFOs Come Into Partial Focus.

Authors:
David E Thaler

J Am Coll Cardiol 2020 May;75(18):2321-2322

Tufts University School of Medicine, Neurology, Tufts Medical Center, Boston, Massachusetts. Electronic address:

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http://dx.doi.org/10.1016/j.jacc.2020.03.038DOI Listing

Atrial Septal Aneurysm, Shunt Size, and Recurrent Stroke Risk in Patients With Patent Foramen Ovale.

J Am Coll Cardiol 2020 May;75(18):2312-2320

Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Université de Paris, INSERM U1266, and FHU Neurovasc, Paris, France. Electronic address:

Background: In patients with patent foramen ovale (PFO)-associated stroke, the presence of large shunt or atrial septal aneurysm (ASA) has been suggested to convey a high risk of stroke recurrence.

Objectives: The purpose of this study was to assess the respective influence of PFO size and ASA status on stroke recurrence under medical therapy in patients with recent PFO-associated stroke without alternative cause.

Methods: The authors pooled individual patient data from 2 prospective observational studies and the medical arms of 2 randomized trials, in which shunt size and ASA status was assessed by independent reading of echocardiographic images. Read More

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http://dx.doi.org/10.1016/j.jacc.2020.02.068DOI Listing

Platypnoea-orthodeoxia syndrome due to deformation of the patent foramen ovale caused by a dilated ascending aorta: a case report.

Eur Heart J Case Rep 2020 Apr 29;4(2):1-4. Epub 2020 Feb 29.

Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa 259-1193, Japan.

Background: Platypnoea-orthodeoxia syndrome (POS) is characterized by dyspnoea and arterial desaturation in the sitting position. Although its pathophysiology is complex and still needed to be investigated, the disease is one of the clinical situations which should be immediately and adequately managed by health care workers from the initial presentation.

Case Summary: A 66-year-old woman with a history of systemic lupus erythematosus, deep vein thrombosis, and lumbar compression fracture was admitted for evaluation of the sudden onset of dyspnoea, while in the sitting position that was relieved on placing her in the supine position. Read More

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http://dx.doi.org/10.1093/ehjcr/ytaa045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7180520PMC

Practice advisory update summary: Patent foramen ovale and secondary stroke prevention: Report of the Guideline Subcommittee of the American Academy of Neurology.

Neurology 2020 May 29;94(20):876-885. Epub 2020 Apr 29.

From the Department of Neurology (S.R.M., S.E.K.), University of Pennsylvania School of Medicine, Philadelphia; Department of Neurology (G.S.G., L.R.), University of Kansas Medical Center, MO; Institute for Clinical Research and Health Policy Studies (D.M.K.), Tufts University School of Medicine, Boston, MA; Cardiology Section (J.R.K.), San Francisco Veterans Affairs Health Care System, and Departments of Medicine, and Epidemiology and Biostatistics (J.R.K.), University of California San Francisco; Division of Cardiology (S.H.), Columbia University Medical Center, New York; Department of Medicine (Cardiology) (J.D.C.), University of Colorado School of Medicine, Aurora; Department of Neurology (K.I.), New York University; and Department of Neurology (N.S.), Kaiser Permanente, Los Angeles, CA.

Objective: To update the 2016 American Academy of Neurology (AAN) practice advisory for patients with stroke and patent foramen ovale (PFO).

Methods: The guideline panel followed the AAN 2017 guideline development process to systematically review studies published through December 2017 and formulate recommendations.

Major Recommendations: In patients being considered for PFO closure, clinicians should ensure that an appropriately thorough evaluation has been performed to rule out alternative mechanisms of stroke (level B). Read More

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http://dx.doi.org/10.1212/WNL.0000000000009443DOI Listing

[Position dependent dyspnea and cyanosis of the lips at the daily round - A case of Platypnea-Orthodeoxia Syndrome].

Dtsch Med Wochenschr 2020 May 29;145(9):619-623. Epub 2020 Apr 29.

Medizinische Klinik II, Klinik für Kardiologie, Rhythmologie und internistische Intensivmedizin, Klinikum Köln-Merheim, Universität Witten-Herdecke, Köln.

History And Clinicial Findings:  We elaborate a case of a 79-year-old patient who presented with position dependent shortness of breath and cyanosis of the lips at the daily round.

Investigations:  In supine position the patient's oxygen saturation was normal > 95 %, in upright position we noticed a reproducible decrease to 76-85 %. Echocardiographic examination revealed a patent foramen ovale (PFO) with spontaneous right-left shunt and additionally a thoracic aortic aneurysm. Read More

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http://dx.doi.org/10.1055/a-1118-2554DOI Listing

Antiplatelet and antithrombotic therapy after patent foramen oval and atrial septal defect closure.

Curr Pharm Des 2020 Apr 26. Epub 2020 Apr 26.

First Department of Cardiology, Medical School of Athens University, Hippokration Hospital, Athens. Greece.

Pathologies of the atrial septum include different interatrial communications varying from patent foramen ovale (PFO) to true defects. Atrial septal defects (ASDs) may be localized within the fossa ovalis such as the secundum type ASD or outside the region of fossa ovalis, such as the ostium primum defect and sinus venosus defect. Over the last decades, the percutaneous closure of interatrial shunts has become a feasible and safe method. Read More

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http://dx.doi.org/10.2174/1385272824999200427083838DOI Listing

Transthoracic echocardiography features of adult-type anomalous left coronary artery from the pulmonary artery before and after surgery: highlights from observational study in a single center of China.

Int J Cardiovasc Imaging 2020 Apr 23. Epub 2020 Apr 23.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510100, China.

To review the imaging characteristics of adult-type anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) and evaluate the post-operative echocardiographic features. The transthoracic echocardiography (TTE) records and invasive coronary angiography (ICA), coronary computed tomography angiography (CTA) or operative findings of thirty adult patients with final diagnosis of ALCAPA were reviewed at our center. The diagnostic reliability of TTE was determined by comparing its results with that of ICA/CTA, and the echocardiographic features of the patients during early visit and post-operative follow-up were summarized. Read More

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http://dx.doi.org/10.1007/s10554-020-01857-xDOI Listing

Persistent left superior vena cava in patient with right atrial myxoma undergoing open heart surgery. A case report and review of literature.

Saudi J Anaesth 2020 Apr-Jun;14(2):217-220. Epub 2020 Mar 5.

Department of Cardiac Surgery, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia.

Persistent left superior vena cava (PLSVC) is a rare and asymptomatic congenital cardiovascular anomaly. Being asymptomatic, PLSVC was usually discovered while performing interventions (such as insertion of central lines, Swan-Ganz catheters, or placing pacemakers) through the left internal jugular vein or left subclavian veins. Commonly, PLSVC is detected not only as an isolated congenital anomaly, but also it can be associated with many other cardiac anomalies. Read More

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http://dx.doi.org/10.4103/sja.SJA_511_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164439PMC

Feasibility of the Figure-of-8-Suture as Venous Closure in Interventional Electrophysiology: One Strategy for All?

Int J Med Sci 2020 6;17(7):965-969. Epub 2020 Apr 6.

Cardiovascular Centre, St. Josef-Hospital, Ruhr-University Bochum, Germany.

: Venous vascular access with higher sheath size is common in interventional electrophysiology. In contrast to arterial vascular access, no dedicated closure devices exist for closure after venous access with higher sheath sizes. The Figure-of-8-Suture, an easy to apply suture, may be as a feasible approach for closure venous puncture. Read More

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http://dx.doi.org/10.7150/ijms.42593DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163359PMC
April 2020
2.003 Impact Factor

Comparison of stroke recurrence between antiplatelet and closure therapy in cryptogenic stroke patients with patent foramen ovale and its influencing factors.

Eur J Intern Med 2020 Apr 16. Epub 2020 Apr 16.

Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), No.568, Zhongxing North Road, Shaoxing, Zhejiang Province 312000 China. Electronic address:

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http://dx.doi.org/10.1016/j.ejim.2020.04.007DOI Listing

Aspirin or anticoagulation after cryptogenic stroke with patent foramen ovale: systematic review and meta-analysis of randomized controlled trials.

Neurol Sci 2020 Apr 18. Epub 2020 Apr 18.

Neurology Clinic, University of Perugia - S. Maria della Misericordia Hospital, Perugia, Italy.

Introduction: Since closure has restrictive eligibility criteria, the vast majority of patients with cryptogenic stroke and patent foramen ovale (PFO) receive medical treatment. However, the optimal antithrombotic strategy is still unclear. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to define risk/benefit profile of anticoagulation compared with antiplatelet treatment in PFO-related stroke. Read More

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http://dx.doi.org/10.1007/s10072-020-04388-4DOI Listing
April 2020
1.495 Impact Factor

Severe Acute Proximal Pulmonary Embolism and COVID-19: A Word of Caution.

Ann Thorac Surg 2020 Apr 16. Epub 2020 Apr 16.

Departement of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Santé, France. Electronic address:

Acute pulmonary embolism is an uncharacteristic presentation in patients with COVID-19. Here we describe the case of a young woman presenting with severe pulmonary embolism, without any associated symptoms of infections. A clot in a patent foramen ovale was noted. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2020.04.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162739PMC

Patent foramen ovale.

Pract Neurol 2020 May 16;20(3):225-233. Epub 2020 Apr 16.

Saint George's University Hospitals NHS Foundation Trust, London, UK.

Patent foramen ovale (PFO) is the most common anatomical cause of an interatrial shunt. It is usually asymptomatic but may cause paradoxical embolism, manifesting as stroke, myocardial infarction or visceral/peripheral ischaemia. PFO is a risk factor for stroke and may be associated with migraine with aura. Read More

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http://dx.doi.org/10.1136/practneurol-2019-002450DOI Listing

Primary and Secondary Prevention of Ischemic Stroke and Cerebral Hemorrhage: JACC Focus Seminar.

J Am Coll Cardiol 2020 Apr;75(15):1804-1818

Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia.

Stroke is a leading cause of permanent disability. Therefore, primary prevention of first stroke and secondary prevention of recurrent stroke are a high priority. Primary prevention of ischemic stroke includes lifestyle modification and diet, treatment of risk factors including hypertension, diabetes mellitus and lipid disorders, antiplatelet therapy for high vascular risk patients, and anticoagulation in atrial fibrillation. Read More

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http://dx.doi.org/10.1016/j.jacc.2019.12.072DOI Listing

Diagnostic Yield of Early Examination for Venous Thrombosis in Patients with Cryptogenic Stroke and a Right-to-left Shunt.

Intern Med 2020 15;59(8):1023-1028. Epub 2020 Apr 15.

Department of Neurology, The Jikei University School of Medicine, Japan.

Objective The presence of deep venous thrombosis (DVT) in a cryptogenic stroke (CS) patient with a right-to-left shunt (RLS) may lead to the development of paradoxical embolism. The aim of the present was to investigate the prevalence of DVT and pulmonary embolism (PE) in CS patients and the clinical features of CS in relation to DVT location and the presence of PE. Methods The medical records of 903 patients with cerebral infarction were retrospectively reviewed. Read More

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http://dx.doi.org/10.2169/internalmedicine.3736-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205525PMC

Potential Embolic Sources and Outcomes in Embolic Stroke of Undetermined Source in the NAVIGATE-ESUS Trial.

Stroke 2020 Jun 16;51(6):1797-1804. Epub 2020 Apr 16.

Population Health Research Institute, Hamilton Health Sciences, ON, Canada (M.S., R.G.H.).

Background and Purpose- Emboli in embolic stroke of undetermined source (ESUS) may originate from various potential embolic sources (PES), some of which may respond better to anticoagulation, whereas others to antiplatelets. We analyzed whether rivaroxaban is associated with reduction of recurrent stroke compared with aspirin in patients with ESUS across different PES and by number of PES. Methods- We assessed the presence/absence of each PES (atrial cardiopathy, atrial fibrillation, arterial atherosclerosis, left ventricular dysfunction, cardiac valvulopathy, patent foramen ovale, cancer) in NAVIGATE-ESUS (New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source) participants. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.028669DOI Listing

The Closure of Patent Foramen Ovale in Preventing Subsequent Neurological Events: A Bayesian Network Meta-Analysis to Identify the Best Device.

Cerebrovasc Dis 2020 14;49(2):124-134. Epub 2020 Apr 14.

Department of Neurology, San Bortolo Hospital, Vicenza, Italy.

Background: Randomized-controlled trials (RCTs) reported a finding on the safety and efficacy of percutaneous patent foramen ovale (PFO) closure to prevent stroke recurrence. It showed that the Amplatzer (AMP) device appears to be superior to medical therapy (MT) in preventing strokes and episodes of atrial fibrillation (AF), than other devices. We performed a network meta-analysis (NMA) to evaluate the closure of PFO in preventing subsequent neurological events while investigating the results obtained by specific devices. Read More

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http://dx.doi.org/10.1159/000507317DOI Listing

Platypnoea-orthodeoxia due to cardiac compression is best treated by plication of the paralysed diaphragm.

Eur J Cardiothorac Surg 2020 Apr 14. Epub 2020 Apr 14.

Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands.

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http://dx.doi.org/10.1093/ejcts/ezaa112DOI Listing

Reply to Welvaart et al.

Eur J Cardiothorac Surg 2020 Apr 14. Epub 2020 Apr 14.

Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, UK.

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http://dx.doi.org/10.1093/ejcts/ezaa113DOI Listing

Management of paradoxical embolism in a patient with coexisting patent foramen ovale and masked pulmonary arteriovenous fistula: A case report.

Medicine (Baltimore) 2020 Apr;99(15):e19507

Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, #261 Huansha Road, Shangcheng District, Hangzhou, Zhejiang Province, China.

Rationale: Paradoxical embolism (PE) is an important cause of cryptogenic stroke, particularly in young patients, which usually have a relation with an unexpected route in circulation. Here we report a rare case of cryptogenic stroke carried 2 uncommon malformations.

Patient Concerns: A 48-year-old female experienced double neurological events in just 2 months. Read More

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http://dx.doi.org/10.1097/MD.0000000000019507DOI Listing

Proposal for Updated Nomenclature and Classification of Potential Causative Mechanism in Patent Foramen Ovale-Associated Stroke.

JAMA Neurol 2020 Apr 13. Epub 2020 Apr 13.

Department of Neurology, Tufts University School of Medicine, Boston, Massachusetts.

Importance: Recent epidemiologic and therapeutic advances have transformed understanding of the role of and therapeutic approach to patent foramen ovale (PFO) in ischemic stroke. Patent foramen ovale is likely responsible for approximately 5% of all ischemic strokes and 10% of those occurring in young and middle-aged adults.

Observations: Randomized clinical trials have demonstrated that, to prevent recurrent ischemic stroke in patients with PFO and an otherwise-cryptogenic index ischemic stroke, PFO closure is superior to antiplatelet medical therapy alone; these trials have provided some evidence that, among medical therapy options, anticoagulants may be more effective than antiplatelet agents. Read More

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http://dx.doi.org/10.1001/jamaneurol.2020.0458DOI Listing

Paradoxical embolism through a patent foramen ovale from central venous catheter thrombosis: A potential cause of stroke.

J Neurol Sci 2020 Apr 4;414:116820. Epub 2020 Apr 4.

Department of Neurology; "SS Annunziata" hospital, Chieti, Italy.

Paradoxical embolism refers to a potential condition in which an embolus arising from a venous source crosses into the systemic circulation through a right-to-left cardiac shunt causing an arterial embolism. A 39-year-old woman carrier of a central venous catheter (CVC) without evident risk factors for stroke, developed an acute right homonymous hemianopia during hemodialysis. On neuroimaging, an infarct in the territory of the left posterior cerebral artery was demonstrated. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116820DOI Listing

Percutaneous Closure of PFO in Patients with Reduced Oxygen Saturation at Rest and during Exercise: Short- and Long-Term Results.

J Interv Cardiol 2020 20;2020:9813038. Epub 2020 Mar 20.

Department of Cardiology, Antwerp Cardiovascular Center, ZNA Middelheim, Antwerp, Belgium.

Background: A patent foramen ovale (PFO) is a rare cause of hypoxemia and clinical symptoms of dyspnea. Due to a right-to-left shunt, desaturated blood enters the systemic circulation in a subset of patients resulting in dyspnea and a subsequent reduction in quality of life (QoL). Percutaneous closure of PFO is the treatment of choice. Read More

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http://dx.doi.org/10.1155/2020/9813038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7109556PMC

Patent Foramen Ovale Closure for Splenic Infarction: An Unusual Presentation and an Unusual Indication.

Case Rep Cardiol 2020 19;2020:9802908. Epub 2020 Mar 19.

Department of Interventional Cardiology, Intercor, Hospital Santo Antonio, Sinop, Brazil.

Background: Splenic infarction is a rare clinical condition. It is generally attributed to hematologic, vascular, cardioembolic, and infectious diseases or trauma. . Read More

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http://dx.doi.org/10.1155/2020/9802908DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115189PMC

Limitations of transoesophageal echocardiogram in acute ischaemic stroke.

Open Heart 2020 24;7(1):e001176. Epub 2020 Mar 24.

Department of Cardiology, Baylor University Medical Center at Dallas, Dallas, Texas, USA.

Objective: The role of transoesophageal echocardiography (TOE) in identifying ischaemic stroke aetiology is debated. In 2018, the American Heart Association/American Stroke Association (AHA/ASA) issued class IIa recommendation for echocardiography, with the qualifying statement of use in cases where it will alter management. Hence, we sought to determine the rate at which TOE findings altered management in cases of confirmed ischaemic stroke. Read More

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http://dx.doi.org/10.1136/openhrt-2019-001176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103838PMC

Undiagnosed Fabry disease: the importance of screening for Fabry disease before transcutaneous patent foramen ovale closure in a young patient with cryptogenic stroke.

J Cardiovasc Med (Hagerstown) 2020 Apr 3. Epub 2020 Apr 3.

Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome.

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http://dx.doi.org/10.2459/JCM.0000000000000952DOI Listing

[Position paper of the Italian Society of Interventional Cardiology (SICI-GISE): Management of patent foramen ovale in patients with cerebral or systemic thromboembolism - 2020].

G Ital Cardiol (Rome) 2020 04;21(4 Suppl 2):50S-59S

U.O.C. Emodinamica, P.O. San Filippo Neri, ASL Roma 1, Roma.

Patent foramen ovale (PFO) is implicated in the pathogenesis of different clinical syndromes in which it plays variable roles. In 2017 and 2018, four randomized clinical trials were published, allowing for the clarification of certain issues pertaining to cryptogenic stroke. Recently, eight European scientific societies collaborated to the writing of an interdisciplinary international position paper on PFO and cryptogenic stroke, based upon best available evidence, with the aim of defining the principles needed to guide decision making. Read More

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http://dx.doi.org/10.1714/3336.33075DOI Listing