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Patent Foramen Ovale Closure

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Catheter-Based Cardiovascular Interventions

Abstract

A patent foramen ovale (PFO) is quite common and persists in approximately 20–30% of adults. In combination with predisposing morphologic and hemodynamic conditions, this remnant interatrial communication promotes thromboembolic events, most notably cerebrovascular events. Feasible treatment strategies include antithrombotic medication (antiplatelet therapy or anticoagulation), surgery, or transcatheter defect closure. Though to date no randomized trials exist showing that medical therapy versus placebo in any patient population with cryptogenic stroke is truly effective in preventing recurrent events, current guidelines promote medical therapy over endovascular or surgical PFO closure as a first-line therapy in patients with cryptogenic stroke and a PFO. This chapter reviews the pathophysiology of presumed paradoxical embolism through a PFO, current guidelines, the history and current status of device technology, and critical aspects to consider when facing a residual shunt after transcatheter PFO closure.

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Authors and Affiliations

  1. CardioVascular Center Frankfurt, Seckbacher Landstrasse 65, Frankfurt, 60389, Germany

    Jennifer Franke M.D., Nina Wunderlich M.D. & Horst Sievert M.D., FSCAI, FACC, FESC, FICA

  2. CardioVascular Center Frankfurt, Seckbacher Landstraße 65, Frankfurt, 60389, Germany

    Stefan C. Bertog M.D.

  3. Department of invasive cardiology, Minneapolis Veterans Affairs Medical Center, 1 Veterens Drive, Minneapolis, MN, 55417, USA

    Stefan C. Bertog M.D.

Authors
  1. Jennifer Franke M.D.
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  2. Nina Wunderlich M.D.
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  3. Stefan C. Bertog M.D.
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  4. Horst Sievert M.D., FSCAI, FACC, FESC, FICA
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Corresponding author

Correspondence to Horst Sievert M.D., FSCAI, FACC, FESC, FICA .

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Editors and Affiliations

  1. , Dept. of Internal Medicine, Gesundheitszentrum Bitterfeld-Wolfen, Friedrich-Ludwig-Jahn-Straße 2, Bitterfeld-Wolfen, 06749, Germany

    Peter Lanzer

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Franke, J., Wunderlich, N., Bertog, S.C., Sievert, H. (2013). Patent Foramen Ovale Closure. In: Lanzer, P. (eds) Catheter-Based Cardiovascular Interventions. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27676-7_39

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  • DOI: https://doi.org/10.1007/978-3-642-27676-7_39

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-27675-0

  • Online ISBN: 978-3-642-27676-7

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