Echocardiography Detection of High-Risk Patent Foramen Ovale Morphology
Keywords:
echocardiography; patent foramen ovale; cryptogenic stroke
Abstract
Patent Foramen Ovale occurs in 25% of the general population1. Several studies suggested that paradoxical embolism through a patent foramen ovale (PFO) correlate with cryptogenic strokes (CS). Many epidemiological and clinical observational studies, showed the association between CS and the presence of PFO. There is still a controversy whether PFO should be closed. The information about PFO morphology might be useful for the management of PFO. This article is discussing a technical information about how echocardiography detects PFO and identifies high risk morphologies for the occurrence of PFO related -stroke.
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References
References
1. Hagen PT, Scholz DG, Edwards WD. Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts. . Mayo Clin Proc 1984; 59: 17-20.
2. Meier B, Kalesan B, Mattle HP, et al. Percutaneous closure of patent foramen ovale in cryptogenic embolism. N Engl J Med 2013; 368(12): 1083-91.
3. Furlan AJ, Reisman M, Massaro J, et al. Closure or medical therapy for cryptogenic stroke with patent foramen ovale. N Engl J Med 2012; 366: 991-9.
4. Carroll JD, Saver JL, Thaler DE, et al. Closure of patent foramen ovale versus medical therapy after cryptogenic stroke. . N Engl J Med 2013; 368: 1092–100.
5. Saver JL, Carroll JD, Thaler DE, et al. Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke. N Engl J Med 2017; 377(11): 1022-32.
6. Lee PH, Song JK, Kim JS, et al. Cryptogenic Stroke and High-Risk Patent Foramen Ovale: The DEFENSE-PFO Trial. J Am Coll Cardiol 2018; 71(20): 2335-42.
7. Sondergaard L, Kasner SE, Rhodes JF, et al. Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke. N Engl J Med 2017; 377(11): 1033-42.
8. Mas JL, Derumeaux G, Guillon B, et al. Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke. N Engl J Med 2017; 377(11): 1011-21.
9. Ntaios G, Papavasileiou V, Sagris D, et al. Closure of Patent Foramen Ovale Versus Medical Therapy in Patients With Cryptogenic Stroke or Transient Ischemic Attack. Updated Systematic Review and Meta-Analysis. Stroke 2018; 494: 412-8.
10. Nakayama R, Takaya Y, Akagi T, et al. Identification of High-Risk Patent Foramen Ovale Associated With Cryptogenic Stroke: Development of a Scoring System. J Am Soc Echocardiogr 2019; 32(7): 811-6.
11. Pristipino C, Sievert H, D'Ascenzo F, et al. European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. Eur Heart J 2019; 40(38): 3182-95.
12. Soliman OII, Geleijnse ML, Meijboom FJ, et al. The use of contrast echocardiography for the detection of cardiac shunts. Eur J Echocardiography 2007; 8: S2 - S12.
13. Gupta SK, Shetkar SS, Ramakrishnan S, Kothari SS. Saline Contrast Echocardiography in the Era of Multimodality Imaging—Importance of “Bubbling It Right”. Echocardiography 2015; 32: 1707–19.
1. Hagen PT, Scholz DG, Edwards WD. Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts. . Mayo Clin Proc 1984; 59: 17-20.
2. Meier B, Kalesan B, Mattle HP, et al. Percutaneous closure of patent foramen ovale in cryptogenic embolism. N Engl J Med 2013; 368(12): 1083-91.
3. Furlan AJ, Reisman M, Massaro J, et al. Closure or medical therapy for cryptogenic stroke with patent foramen ovale. N Engl J Med 2012; 366: 991-9.
4. Carroll JD, Saver JL, Thaler DE, et al. Closure of patent foramen ovale versus medical therapy after cryptogenic stroke. . N Engl J Med 2013; 368: 1092–100.
5. Saver JL, Carroll JD, Thaler DE, et al. Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke. N Engl J Med 2017; 377(11): 1022-32.
6. Lee PH, Song JK, Kim JS, et al. Cryptogenic Stroke and High-Risk Patent Foramen Ovale: The DEFENSE-PFO Trial. J Am Coll Cardiol 2018; 71(20): 2335-42.
7. Sondergaard L, Kasner SE, Rhodes JF, et al. Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke. N Engl J Med 2017; 377(11): 1033-42.
8. Mas JL, Derumeaux G, Guillon B, et al. Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke. N Engl J Med 2017; 377(11): 1011-21.
9. Ntaios G, Papavasileiou V, Sagris D, et al. Closure of Patent Foramen Ovale Versus Medical Therapy in Patients With Cryptogenic Stroke or Transient Ischemic Attack. Updated Systematic Review and Meta-Analysis. Stroke 2018; 494: 412-8.
10. Nakayama R, Takaya Y, Akagi T, et al. Identification of High-Risk Patent Foramen Ovale Associated With Cryptogenic Stroke: Development of a Scoring System. J Am Soc Echocardiogr 2019; 32(7): 811-6.
11. Pristipino C, Sievert H, D'Ascenzo F, et al. European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. Eur Heart J 2019; 40(38): 3182-95.
12. Soliman OII, Geleijnse ML, Meijboom FJ, et al. The use of contrast echocardiography for the detection of cardiac shunts. Eur J Echocardiography 2007; 8: S2 - S12.
13. Gupta SK, Shetkar SS, Ramakrishnan S, Kothari SS. Saline Contrast Echocardiography in the Era of Multimodality Imaging—Importance of “Bubbling It Right”. Echocardiography 2015; 32: 1707–19.
Published
2021-09-16
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How to Cite
Soesanto, A. (2021). Echocardiography Detection of High-Risk Patent Foramen Ovale Morphology. Indonesian Journal of Cardiology, 42(3). https://doi.org/10.30701/ijc.1098
Section
Review Article
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