title: Percutaneous PFO closure for paradoxical stroke in 8-kg twins.
abstract: Patent foramen ovale (PFO) is a known risk factor for paradoxical embolus, especially in the presence of other risk factors such as hypercoagulable states or central lines. A PFO is a common incidental finding in infants and children. However, paradoxical emboli are not common in infants, and so PFO closure is rarely indicated in this age group. We present two cases of PFO closures in identical 8 kg twin boys with Hurler's syndrome who had central lines for planned bone marrow transplants, with embolic stroke in one. We discuss the treatment options as well as the specific challenges based on the patients' age, size, and diagnoses. We also discuss the technical aspects and safety of percutaneous PFO closure.
authors.affiliation: Department of Pediatric Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: James
authors.initials: J
authors.lastname: Hill
authors.forename: Tamar
authors.initials: T
authors.lastname: Preminger
mesh_terms: D001835:Body Weight; D006328:Cardiac Catheterization / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004200:Diseases in Twins; D018618:Echocardiography, Doppler, Color; D019320:Embolism, Paradoxical / Q000209:etiology*; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D020766:Intracranial Embolism / Q000209:etiology*; D008297:Male
keywords: ASD; Helex; PFO; infant; paradoxical; pediatric; stroke