title: Setting up a multidisciplinary program for management of patent foramen ovale-mediated syndromes.
abstract: BACKGROUND
  These days no codified multidisciplinary protocol has been reported to manage all the different patent foramen ovale (PFO)-mediated syndromes. We sought to propose a multidisciplinary program of diagnosis, treatment, and follow-up of all PFO-mediated syndromes based on an in-hospital multidisciplinary task force and to review the activities during the first year.
  
  
  METHODS
  From September 2004, we organized in our hospital, a 600-bed tertiary hospital, a management program for PFO-mediated syndromes based on a task force composed of cardiologists, neurologists, and internists. Different levels of protocols were created in order to cover diagnosis, treatment, and follow-up of PFO-mediated syndromes. We reviewed the activity of our program in the first year up to September 2005.
  
  
  RESULTS
  Thirty-five patients (23 female, mean age 65 +/- 24 years) were evaluated for suspected PFO-mediated syndromes: 20 for cryptogenic stroke, 2 for peripheral and coronary embolisms, 3 for platypnea-orthodeoxia, 9 for emicrania with aura, and 1 with hypoxiemia during neurosurgical intervention in the posterior cranial fossa. Diagnosis of PFO was confirmed in 25 patients. According to the multidisciplinary protocols, 15 patients failed to meet the requirements for transcatheter closure and were left in medical therapy whereas 11 patients (7 patients with PFO, 2 with multiperforated ASD, and 2 with a secundum ASD) underwent transcatheter closure. After a mean follow-up of 10.8 +/- 4.9 months, no recurrent PFO syndromes were noted in patients treated with devices.
  
  
  CONCLUSIONS
  The first year of our multidisciplinary program allowed a reasonable and potentially successful approach for correctly identifying patients with PFO-mediated syndromes until randomized studies are completed.
authors.affiliation: Interventional Cardiology Unit, Rovigo General Hospital, Rovigo, Italy. jackyheart@hotmail.com
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rigatelli
authors.forename: Gabriele
authors.initials: G
authors.lastname: Braggion
authors.forename: Maurizio
authors.initials: M
authors.lastname: Chinaglia
authors.forename: Paolo
authors.initials: P
authors.lastname: Cardaioli
authors.forename: Loris
authors.initials: L
authors.lastname: Roncon
authors.forename: Massimo
authors.initials: M
authors.lastname: Giordan
authors.forename: Stefano
authors.initials: S
authors.lastname: Cuppini
authors.forename: Silvio
authors.initials: S
authors.lastname: Aggio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bortolazzi
authors.forename: Pietro
authors.initials: P
authors.lastname: Zonzin
mesh_terms: D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D016730:Program Development; D011446:Prospective Studies; D013577:Syndrome; D016896:Treatment Outcome