title: Percutaneous closure of patent foramen ovale: safe and effective but underutilized.
abstract: With three recently published randomized trials on patent foramen ovale (PFO) closure, the concept of PFO closure to reduce recurrent strokes has been proven; however, PFO closure is currently only considered for secondary prevention. Given the potential devastating consequences of a PFO-related event, we advocate screening for and closure of a PFO for primary prevention in high-risk populations. Such populations include patients who are suffering from a disease that is associated with PFO (e.g., migraine) or patients with high-risk hobbies/professions (e.g., weight-lifters, frequent-flyers, and deep sea divers). Looking at young people with a remaining average life expectancy of 50 years, we have to close 2.4 PFOs to prevent one stroke. This should support a more proactive attitude toward PFO screening and closure.
authors.affiliation: University Heart Center Zurich, Zurich, Switzerland.
authors.forename: Fabian
authors.initials: F
authors.lastname: Nietlispach
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization / Q000295:instrumentation; D005260:Female; D054092:Foramen Ovale, Patent / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D055502:Secondary Prevention / Q000639:trends*; D055989:Septal Occluder Device / Q000639:trends*; D020521:Stroke / Q000517:prevention & control* / Q000628:therapy; D016896:Treatment Outcome
keywords: migraine; patent foramen ovale; percutaneous PFO closure; prevention; stroke