title: Morphological features pertinent to interventional closure of patent oval foramen.
abstract: Despite the growing trend of device closure for patent ovale foramens (PFO), the morphology of these lesions is much neglected. A better understanding of the morphological aspects is needed for developing lesion-specific devices. We reviewed ten heart specimens and distinguished two forms of PFO: valve competent and valve incompetent. In the valve-competent form, the thin valve of the oval foramen adequately overlaps the firmer muscular rim of the foramen, leaving a crevice-like aperture sandwiched between the two structures. In contrast, the valve-incompetent form results from aneurysmal ballooning of the valve, or stretching of the muscular rim, creating an interatrial communication in a previously competent flap valve. Distinguishing between the two forms can help in designing and selecting the most appropriate device for implantation.
authors.affiliation: National Heart and Lung Institute, Imperial College, Royal Brompton and Harefield Hospital, NHS Trust, London, United Kingdom. yen.ho@imperial.ac.uk
authors.forename: Siew Yen
authors.initials: SY
authors.lastname: Ho
authors.forename: Karen P
authors.initials: KP
authors.lastname: McCarthy
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rigby
mesh_terms: D001022:Aortic Valve Insufficiency / Q000473:pathology / Q000601:surgery; D006348:Cardiac Surgical Procedures; D006322:Heart Aneurysm / Q000473:pathology / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000473:pathology* / Q000601:surgery*; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D008955:Models, Cardiovascular; D014654:Vascular Patency / Q000502:physiology