title: Percutaneous closure of patent foramen ovale: an underutilized prevention?
abstract: Stroke is a devastating event for patients and their families. Paradoxical embolism through a patent foramen ovale (PFO) is a recognized cause of stroke. Percutaneous PFO closure is a simple and safe procedure. The debate on PFO closure is far from settled. This is, in part, due to the fact that the three published randomized controlled trials (RCTs) on PFO closure vs. medical therapy were negative regarding their primary endpoint; however, as-treated and per-protocol analyses as well as several meta-analyses report a benefit of PFO closure. In our opinion, PFO closure is underutilized and the results of the three RCTs are not adequately reflected in the current guidelines.
authors.affiliation: Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland fabian.nietlispach@usz.ch nietlispachf@aol.com.
authors.forename: Fabian
authors.initials: F
authors.lastname: Nietlispach
authors.affiliation: Department of Cardiology, Bern University Hospital, Bern, Switzerland.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
mesh_terms: D019320:Embolism, Paradoxical; D054092:Foramen Ovale, Patent; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D055989:Septal Occluder Device; D020521:Stroke; D016896:Treatment Outcome
keywords: PFO closure; Paradoxical embolism; Percutaneous; Prevention; Stroke