title: Three-dimensional imaging of the atrial septum and patent foramen ovale anatomy: defining the morphological phenotypes of patent foramen ovale.
abstract: Patent foramen ovale (PFO) is known to occur with greater prevalence in those with cryptogenic stroke. These observations support the role of a PFO as a channel for paradoxical embolism and a mechanism for cerebral ischaemic events. Transcatheter closure of PFO may be indicated in this setting. A prerequisite of procedural success is achieving complete closure of the shunt. Studies have shown a varying degree of successful shunt closure. Residual shunts are usually the result of a mismatch between the device shape and PFO anatomy. In this article, we review the features of PFO and their surrounding structures as seen by three-dimensional transoesophageal echocardiography in patients undergoing transcatheter closure and relate these to the variations in morphology on anatomical specimens for a better appreciation of their suitability for closure devices. The salient features of the anatomical variations seen in adults undergoing transcatheter device closure have been summarized and used to produce a practical pre-procedural checklist.
authors.affiliation: Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK.
authors.forename: Bushra S
authors.initials: BS
authors.lastname: Rana
authors.forename: Len M
authors.initials: LM
authors.lastname: Shapiro
authors.forename: Karen P
authors.initials: KP
authors.lastname: McCarthy
authors.forename: Siew Yen
authors.initials: SY
authors.lastname: Ho
mesh_terms: D054087:Atrial Septum / Q000000981:diagnostic imaging* / Q000601:surgery; D006328:Cardiac Catheterization; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D054085:Foramen Ovale / Q000000981:diagnostic imaging*; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D010641:Phenotype