[Patent foramen ovale and decompression illness in divers].
BACKGROUND
About 25 % of the population has patent foramen ovale, and the condition has been assumed to be a causal factor in decompressive illness. Transcatheter closure is possible and is associated with a relatively low risk, but it has not been clarified whether there is an indication for assessment and treatment of the condition in divers. The present study explored a possible relationship between a patent foramen ovale and the risk for decompression illness in divers, if there are categories of divers that should be screened for the condition and what advice should be given to divers with this condition.


METHODS
The review is based on literature identified through a search in Pubmed and the authors' long clinical experience in the field.


RESULTS
The risk of decompression illness for divers with a persistent foramen ovale is about five times higher than that in divers without this condition, but the absolute risk for decompression illness is only 2.5 after 10,000 dives. A causal association has not been shown between patent foramen ovale and decompression illness. Even if closure of patent foramen ovale may be done with relatively small risk, the usefulness of the procedure has not been documented in divers.


CONCLUSIONS
We do not recommend screening for patent foramen ovale in divers because the absolute risk of decompression illness is small and transcatheter closure is only indicated after decompression illness in some occupational divers.
Sivertsen
Wiebke
W
Seksjon for pediatri, Institutt for klinisk medisin, Universitetet i Bergen, Norway.
Risberg
Jan
J
Norgård
Gunnar
G
D003665:Decompression Sickness / Q000209:etiology*; D004242:Diving / Q000293:injuries*; D017548:Echocardiography, Transesophageal; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D016272:Occupational Health; D012307:Risk Factors