6,062 results match your criteria Patent Foramen Ovale

Management of the Patient With Patent Foramen Ovale in 2021: A Spectrum of Cases.

Mayo Clin Proc 2021 May;96(5):1356-1362

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN; Sheikh Shakbout Medical City, Abu Dhabi, United Arab Emirates.

Patients with patent foramen ovale can manifest in a variety of ways. These presentations and their resolution are discussed in this article. Read More

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Localization of Infratentorial Lesion could Predict Patent Foramen Ovale as an Etiology in Embolic Stroke of Undetermined Source.

J Atheroscler Thromb 2021 May 1. Epub 2021 May 1.

Department of Neurology, Tokyo Women's Medical University School of Medicine.

Aim: Embolic stroke of undetermined source (ESUS) is a clinical construct introduced to describe cryptogenic stroke cases with ambiguous diagnoses. Cardiac causes are recognized as a major cause of ESUS, Patent foramen ovale (PFO) being among them. We aimed to investigate the relationship between infarct patterns and PFO in patients with ESUS. Read More

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The Incidence of Congenital Heart Defects in Offspring Among Women With Diabetes in Saudi Arabia.

Cureus 2021 Mar 31;13(3):e14225. Epub 2021 Mar 31.

Biostatistics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.

Background: The risk of congenital anomalies is increased in infants of diabetic mothers (IDM). The most frequent cardiac anomalies in IDMs include ventricular septal defect, transposition of great arteries, and aortic stenosis.

Objective: Estimating the incidence of infants with congenital heart defects (CHD) whose mothers have diabetes in Saudi Arabia at a tertiary hospital in the National Guard Health Affairs (NGHA) system. Read More

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Patent Foramen Ovale Closure In Stroke Patients With Migraine In The Close Trial. The Close-Mig Study.

Eur J Neurol 2021 May 3. Epub 2021 May 3.

Stroke unit, Department of Neurology, University Hospital of Nantes, Nantes, France.

Background: The efficacy of patent foramen ovale (PFO) closure to reduce the frequency of migraine attacks remains controversial.

Methods: Planned sub-study in migraine patients enrolled in a randomized, clinical trial designed to assess the superiority of PFO closure plus antiplatelet therapy over antiplatelet therapy alone to prevent stroke recurrence in patients younger than 60 years with a PFO-associated cryptogenic ischemic stroke. The main outcome was the mean annual number of migraine attacks in migraine patients with aura and in those without aura, as recorded at each follow-up visit by study neurologists. Read More

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Use of the NobleStitch™ EL for the treatment of patients with residual right-to-left shunt following device closure of PFO.

Clin Case Rep 2021 Apr 11;9(4):1929-1932. Epub 2021 Feb 11.

INOVA Children's Hospital Falls Church VA USA.

The unique design of the NobleStitch™ EL allows it to be used to close residual defects following failed device PFO closure without impacting the integrity of previously placed double-disk Gore occluders. Read More

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Presence of Atrial Fibrillation in Stroke Patients With Patent Foramen Ovale: Systematic Review and Meta-Analysis.

Front Neurol 2021 15;12:613758. Epub 2021 Apr 15.

Department of Neurology, Austin Health, Heidelberg, VIC, Australia.

Patent foramen ovale (PFO) is associated with ischemic stroke, especially in patients with embolic stroke of undetermined source. This study aims to evaluate the presence of atrial fibrillation (AF) in ischemic stroke patients with PFO. We systematically searched EMBASE and MEDLINE databases on May 21, 2020 for studies that analyzed the presence of AF in patients with PFO. Read More

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[Secondary stroke prevention after TIA or ischemic stroke].

Herz 2021 Apr 29. Epub 2021 Apr 29.

Herzzentrum, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Deutschland.

Stroke is one of the main causes of mortality and permanent disability. Secondary prevention of stroke recurrence therefore has a high priority. Secondary prevention of ischemic stroke includes optimization of the lifestyle and diet, treatment of risk factors, such as hypertension, diabetes mellitus and hyperlipidemia, prophylaxis of recurrence with antiplatelet treatment in patients with high vascular risk and anticoagulation in atrial fibrillation. Read More

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[Paradox embolism in a patient with pulmonary embolism and unknown patent foramen ovale].

Ugeskr Laeger 2021 Apr;183(15)

This case report describes a 64-year-old male patient, who presented with sudden onset dyspnoea. A chest CT-angiography revealed the presence of central bilateral pulmonary embolisms (PE), and he was admitted for anticoagulative treatment. Shortly after admission, he developed discomfort and pulselessness in the right leg, and a limb CT-angiography revealed a femoral artery thrombus. Read More

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Identification of an Intracardiac Shunt in a Patient With Recurrent Cryptogenic Strokes: Are Dextrose Solutions More Sensitive?

CASE (Phila) 2021 Apr 7;5(2):123-125. Epub 2021 Jan 7.

Division of Cardiology, Department of Internal Medicine, Hennepin Healthcare, Minneapolis, Minnesota.

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Effect of right-to-left shunt on youth benign paroxysmal positional vertigo: A prospective clinical study.

Clin Neurol Neurosurg 2021 Apr 20;205:106646. Epub 2021 Apr 20.

Department of Neurology, The Second Clinical Medical College of Jinan University (Shenzhen People's Hospital; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong 518020, China. Electronic address:

Objective: To evaluate the correlation between right to left shunt (RLS) and youth benign paroxysmal positional vertigo (YBPPV).

Patients And Methods: Patients with benign paroxysmal positional vertigo (BPPV) and normal control cases younger than 45 years were enrolled at 1:1 ratio. Contrast-enhanced transcranial doppler ultrasound was performed to determine the existence and shunt grading of RLS. Read More

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Acute Intraoperative Hypoxemia During Right Pneumonectomy-The Heart and Lung Interaction: A Case Report.

A A Pract 2021 Apr 27;15(4):e01454. Epub 2021 Apr 27.

Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

A 75-year-old woman with a history of right-upper lobectomy for adenocarcinoma presented for a right completion pneumonectomy due to 2 new fluorodeoxyglucose-avid densities on the remaining lung. After uneventful anesthetic induction and surgical resection with modest blood loss, the patient developed refractory hypoxemia on emergence without significant hemodynamic changes. Despite delivery of fraction of inspired oxygen (Fio2) = 1. Read More

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The Gore Septal Occluder (GSO) for Multiple Indications in Children - An Intention to Treat Analysis.

Heart Lung Circ 2021 Apr 23. Epub 2021 Apr 23.

Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, Qld, Australia; Queensland Paediatric Cardiac Research Group, Brisbane, Qld, Australia; University of Queensland, Brisbane, Qld, Australia. Electronic address:

Objective: To assess the safety and efficacy of all uses of the Gore septal occluder (GSO) (WL Gore and Associates, Flagstaff, AZ, USA) in a tertiary children's hospital.

Background: The GSO is widely used in atrial septal communication closure in the adult population. Usage in the paediatric population is expanding. Read More

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Right Atrial Appendage Thrombus in Atrial Fibrillation: A Case Report and Review of the Literature.

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:23247096211010048

University of Florida, Jacksonville, FL, USA.

Atrial fibrillation (Afib) is the most common abnormal heart rhythm in adults and has become a significant public health concern affecting 2% to 3% of the population in Europe and North America. Left atrial appendage (LAA) thrombi is the source of 90% of left-sided cardiac thrombi in patients with Afib, which can cause stroke and other systemic vascular events. Right atrial appendage (RAA) thrombi formation in Afib is much less common but complications include pulmonary embolism or paradoxical migration across patent foramen ovale with risk of systemic embolization. Read More

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The Prevalence of Microembolic Signals in Transcranial Doppler Sonography with Bubble Test in Acute Ischemic Stroke.

J Ultrasound Med 2021 Apr 22. Epub 2021 Apr 22.

Department of Neurology, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.

Objectives: Transcranial Doppler ultrasound (TCD) is noninvasive and highly sensitive and specific for the diagnosis of patent foramen ovale (PFO). We evaluated the diagnostic implications of the TCD with a saline agitation test as a routine work-up for ischemic stroke patients.

Methods: A TCD bubble study was performed in all consecutive ischemic stroke patients as a routine work-up. Read More

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Hypoxia due to unusual right to left shunt after arterial switch surgery.

Ann Card Anaesth 2021 Apr-Jun;24(2):241-243

Institute of Heart and Lung Transplant and Mechanical Circulatory Support, MGM Healthcare Pvt Ltd., New No. 72, Old No.54, Nelson Manickam Road, Aminjikarai, Chennai-29, Postal Code-600 029, India.

Hypoxia can occur after repair of transposition of great arteries. The most common cause of right to left shunt after arterial switch surgery is related to increased right ventricular pressures and persistent neonatal pulmonary arterial hypertension. We report a case of TGA repair causing right to left shunt with normal right ventricular pressures. Read More

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Peripheral thrombosis causing simultaneous saddle pulmonary embolism and paradoxical ST elevation myocardial infarction resulting in cardiovascular collapse.

BMJ Case Rep 2021 Apr 21;14(4). Epub 2021 Apr 21.

Department of Cardiology, St Vincent Hospital, Worcester, Massachusetts, USA.

Paradoxical coronary artery embolism is often an underdiagnosed cause of acute myocardial infarction (MI). It should always be considered in patient with acute MI and a low risk profile for atherosclerotic coronary artery disease. We describe a patient with simultaneous acute saddle pulmonary embolism (PE) and acute ST segment elevation MI due to paradoxical coronary artery embolism. Read More

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Right-to-left shunt detection using transforaminal insonation of the basilar artery.

J Neuroimaging 2021 Apr 20. Epub 2021 Apr 20.

Department of Neurology, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona, USA.

Background And Purpose: Investigation for patent foramen ovale (PFO) is warranted in patients with cryptogenic stroke (CS), as PFO closure is recommended in select CS patients for secondary stroke prevention. Transcranial Doppler (TCD) is noninvasive and has high sensitivity for PFO screening. However, 10% of the population has insufficient temporal bone windows to perform standard TCD monitoring of the middle cerebral arteries (MCAs). Read More

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Patent foramen ovale revealed by COVID-19 pneumonia.

BMC Pulm Med 2021 Apr 19;21(1):126. Epub 2021 Apr 19.

Department of Pneumology, CHU Erasme Hospital, Université Libre de Bruxelles, Bruxelles, Belgium.

Background: Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation-perfusion mismatch and others intrapulmonary abnormalities are involved.

Case Presentation: We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. Read More

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Thrombophilia Testing After Ischemic Stroke: Why, When, and What?

Stroke 2021 May 20;52(5):1874-1884. Epub 2021 Apr 20.

Clinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York (B.B.N.).

Thrombophilia testing is frequently performed after an ischemic stroke, particularly when cryptogenic. However, there is minimal evidence supporting a significant association between most conditions assessed through thrombophilia testing and ischemic stroke, and the rationale for thrombophilia testing in many clinical situations remains uncertain. In this topical review, we review and contextualize the existing data on the risks, predictors, and outcomes of thrombophilic conditions in patients with ischemic stroke. Read More

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Transcatheter Closure of Patent Foramen Ovale: Not Always an "Open or Shut" Case.

Circulation 2021 Apr 19;143(16):1539-1541. Epub 2021 Apr 19.

Division of Cardiology, Duke University Health System, Durham, NC (R.A.K.).

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Ischemic Stroke in the Young.

Clin Appl Thromb Hemost 2021 Jan-Dec;27:10760296211002274

Department of Neurology, Comprehensive Stroke Center Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

The purpose of this article is to address several challenging questions in the management of young patients (those age 60 and under) who present with ischemic stroke. Do genetic thrombophilic states, strongly associated with venous thrombosis, independently cause arterial events in adults? Should cases of patent foramen ovale be closed with mechanical devices in patients with cryptogenic stroke? What are the optimal treatments for cerebral vein thrombosis, carotid artery dissection, and antiphospholipid syndrome and are DOACs acceptable treatment for these indications? What is the mechanism underlying large vessel stroke in patients with COVID-19? This is a narrative review. We searched PubMed and Embase and American College of physicians Journal club database for English language articles since 2000 looking mainly at randomized clinical trials, Meta analyses, Cochran reviews as well as some research articles viewed to be cutting edge regarding anticoagulation and cerebrovascular disease. Read More

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Comparative analysis of the diagnostic value of several methods for the diagnosis of patent foramen ovale.

Echocardiography 2021 Apr 18. Epub 2021 Apr 18.

Department of Cardiology, Shandong University Qilu Hospital, Jinan, China.

The aim of this research was to compare the sensitivity and positive predictive value of contrast transcranial Doppler (c-TCD), contrast transthoracic echocardiography (c-TTE), and contrast transesophageal echocardiography (c-TEE), to determine the best method for diagnosing patent foramen ovale (PFO) and to provide a reference for the further improvement of clinical practice. We investigated 161 patients who suffered from migraines, cryptogenic stroke, TIA, and cerebral infarction of unknown cause. All patients underwent transcatheter examination, and the results of the right heart catheterization (RHC) were considered the gold standard for PFO diagnosis. Read More

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Investigation of echocardiographic characteristics and predictors for persistent defects of patent foramen ovale or patent ductus arteriosus in Chinese newborns.

Biomed J 2021 Apr 15. Epub 2021 Apr 15.

Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan; Center for Shockwave Medicine and Tissue Engineering, Department of Medical Research, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address:

Background: Persistent patent foramen ovale (PFO) and patent ductus arteriosus (PDA) increase the adult risk of cryptogenic embolic stroke and chronic pulmonary hypertension. To understand the characteristics of PFO and PDA in newborns, we investigated the spontaneous closure rate and derived the determinants for residual defects.

Methods: We utilized the database of congenital heart disease (CHD) in Xiamen ChangGung Memorial Hospital from 2015 to 2017 and allocated 2523 eligible newborns into four groups according to PDA, PFO, both or neither at birth. Read More

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Strange Bedfellows: Migraine Headache and Patent Foramen Ovale.

Joseph S Alpert

Am J Med 2021 Apr 13. Epub 2021 Apr 13.

Professor of Medicine, University of Arizona College of Medicine, Sarver Heart Center, Tucson AZ; Editor in Chief, The American Journal of Medicine. Electronic address:

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Severe hypoxemia and stroke caused by a patent foramen ovale with right-to-left interatrial shunt despite normal right atrial pressures.

Int J Cardiol Heart Vasc 2021 Jun 25;34:100759. Epub 2021 Mar 25.

Department of Cardiology, Angiology and Intensive Care, Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany.

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Antithrombotic Therapy for Stroke Patients with Cardiovascular Disease.

Semin Neurol 2021 Apr 13. Epub 2021 Apr 13.

Mobile Stroke Unit, Memorial Hermann Hospital, Texas Medical Center, Houston.

Prevention of ischemic stroke relies on the use of antithrombotic medications comprising antiplatelet agents and anticoagulation. Stroke risk is particularly high in patients with cardiovascular disease. This review will focus on the role of antithrombotic therapies in the context of different types of cardiovascular disease. Read More

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Response to "Comment on 'Clopidogrel can be an effective complementary prophylactic for drug-refractory migraine with patent foramen ovale'".

Yichen Guo

J Investig Med 2021 Apr 13. Epub 2021 Apr 13.

Department of Neurology, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China

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Management of straddling thrombus through patent foramen ovale complicating pulmonary embolism.

BMJ Case Rep 2021 Apr 13;14(4). Epub 2021 Apr 13.

Intensive Care Unit, Nepean Hospital ICU, Kingswood, New South Wales, Australia.

A 60-year-old man was admitted to intensive care unit with the diagnosis of pulmonary embolism. Bedside transthoracic echocardiography revealed the extension of the thrombus into left atrium and ventricle through patent foramen ovale (PFO). A straddling thrombus also described as impending paradoxical embolism is a rare condition when thrombus embolised to the heart gets caught in PFO. Read More

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Comment on "Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale".

Acta Orthop Traumatol Turc 2021 Mar;55(2):189-190

Department of Underwater and Hyperbaric Medicine, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey.

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Platypnea-orthodeoxia syndrome in a child: relief of symptoms after transcatheter closure of patent foramen ovale.

Cardiol Young 2021 Apr 12:1-3. Epub 2021 Apr 12.

Department of Pediatric Cardiology, Koç University Faculty of Medicine, İstanbul, Turkey.

Platypnea-orthodeoxia syndrome is a rare clinical entity characterised by positional dyspnoea and arterial desaturation while in the upright position, the symptoms generally occurring in adults. We describe a 12-year-old girl diagnosed with platypnea-orthodeoxia syndrome associated with patent foramen ovale. The symptoms resolved following percutaneous patent foramen ovale closure. Read More

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