Maximal potential patent foramen diameter does not correlate with the type or frequency of the neurologic event prior to closure.
BACKGROUND
We analyzed our data on patients undergoing transcatheter patent foramen ovale (PFO) closure to determine if the maximal potential PFO diameter (MPPD) by balloon sizing correlates with important clinical characteristics in this population.


METHODS
We defined stroke as a focal neurologic deficit lasting >24 h, or focal deficit of shorter duration associated with permanent MRI/CT changes consistent with a focal infarction. Parameters analyzed included age, gender, anticoagulation, hypertension, smoking, MRI/CT findings and MPPD at catheterization. We specifically analyzed the type of neurologic event (stroke/transient ischemic attack, TIA), and number of recorded preceding clinical neurologic events.


RESULTS
In 216 consecutive patients, 167 suffered a stroke. MRI/CT changes consistent with one or more embolic events were seen in 156 patients; 49 had a clinical TIA. There was no significant difference in MPPD between stroke (11.0 +/- 3.6 mm) and TIA groups (10.9 +/- 3.9 mm; 95% confidence interval for difference: -1.33 to 1.00). MPPD did not differ between MRI/CT-positive vs. -negative strokes, and had no correlation with the number of identified pre-closure clinical neurologic events.


CONCLUSIONS
Continued investigation is needed to determine whether other PFO characteristics, or other anatomic/physiologic parameters, may be useful to identify patients at high risk for cryptogenic stroke/TIA, even before they have their first neurologic event.
Kutty
Shelby
S
University of Nebraska/Creighton University Joint Division of Pediatric Cardiology, Children's Hospital of Omaha, Omaha, NE, USA.
Brown
Kimberly
K
Qureshi
Athar M
AM
Latson
Larry A
LA
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D006328:Cardiac Catheterization; D005260:Female; D054092:Foramen Ovale, Patent / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D020766:Intracranial Embolism / Q000453:epidemiology*; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*; D055815:Young Adult
D000925:Anticoagulants