Author + information
- Received October 2, 2017
- Revision received November 30, 2017
- Accepted December 22, 2017
- Published online February 26, 2018.
- Mohammad K. Mojadidi, MDa,
- Muhammad O. Zaman, MDa,
- Islam Y. Elgendy, MDa,
- Ahmed N. Mahmoud, MDa,
- Nimesh K. Patel, MDb,
- Nayan Agarwal, MDc,
- Jonathan M. Tobis, MDd and
- Bernhard Meier, MDe,∗ ()
- aDivision of Cardiology, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida
- bDivision of Cardiology, Department of Medicine, Virginia Commonwealth University, Richmond, Virginia
- cInterventional Cardiology, Cardiovascular Institute of the South, Houma, Louisiana
- dProgram in Interventional Cardiology, Division of Cardiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
- eDepartment of Cardiology, University Hospital of Bern, Bern, Switzerland
- ↵∗Address for correspondence:
Prof. Bernhard Meier, Department of Cardiology, University Hospital, Freiburgstrasse, 3010 Bern, Switzerland.
Nearly one-half of patients with cryptogenic stroke have a patent foramen ovale (PFO). The dilemma of whether to close these PFOs percutaneously, in an effort to reduce the risk of recurrent paradoxical embolism, has been a matter of ongoing debate for more than a decade. Early randomized clinical trials failed to demonstrate a significant benefit of percutaneous PFO closure for secondary prevention of cryptogenic stroke in an intention-to-treat analysis. The long-term follow-up data from the RESPECT trial and 2 new randomized trials (CLOSE and REDUCE) have clarified these findings. They showed that with good patient selection, transcatheter PFO closure significantly reduces the risk of recurrent stroke compared with medical therapy in patients with cryptogenic stroke, with no increased risk of serious adverse events or influence on major bleeding.
- patent foramen ovale
- right-to-left shunt
- septal occluder
- transesophageal echocardiography
- transient ischemic attack
Dr. Tobis has served as a consultant for St. Jude Medical and W.L. Gore; as a coinvestigator of the RESPECT trial; and as a proctor for Cardiac Dimensions. Dr. Meier has served on the Speakers Bureau for Abbott; has received speaker fees from Abbott; and has served as a co-primary investigator of the PC trial. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 2, 2017.
- Revision received November 30, 2017.
- Accepted December 22, 2017.
- 2018 American College of Cardiology Foundation
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