The advantageous safety features of the Amplatzer PFO Occluder have enabled it to be preferred in other two RCTs: the RESPECT (Randomized Evaluation of Recurrent Stroke Comparing PFO Closure to Established Current Standard of Care Treatment) and the PC (Clinical Trial Comparing Percutaneous Closure of Patent Foramen Ovale
(PFO) Using the Amplatzer PFO Occluder with Medical Treatment in Patients with Cryptogenic Embolism) (39,40).
According to an NHS report on patent foramen ovale
closures (PFOC), carried out by the Newcastle and York External Assessment Centre, it states that carrying out the procedure in NHS England is not cost-effective.
Long-term outcomes of patent foramen ovale
closure or medical therapy after stroke.
In this study, the overall detection rate of occult cerebral infarction by TEE was 32.0%, higher than 8% by TTE, and moreover TEE was more sensitive in the detection of aortic plaques, patent foramen ovale
, atrial septal aneurysm and atrial septal defect, indicating the high application values of TEE in the diagnosis of occult cerebral infarction.
Lastly we discovered evidence of likely Patent Foramen Ovale
in our patients, yet no proof of an embolic source was substantiated.
Subsequently, a transesophageal echocardiogram (TEE) was performed that revealed a patent foramen ovale
with right-to-left shunt.
As the IVC catheter was advanced to its full length and sutured in place overlying the L3 vertebral body, proximal catheter migration was not possible, such that the left to right shunt across the patent foramen ovale
did not contribute to an increased IVC S[O.sub.2].
Patent foramen ovale
was defined on the basis of transesophageal echocardiographic evidence of a separation between the septum primum and septum secundum, with the demonstration of right-to-left shunt by contrast injection .
Patent foramen ovale
increases the risk for paradoxical embolism and this may result in neurological disorders related to ischemia (stroke or TIA) .
Inherited thrombophilic disorders in young adults with ischemic stroke and patent foramen ovale
. Stroke 2003; 34:28-33.
Given this widespread distribution, it is unlikely that a single embolic or iatrogenic source plus a structural cardiac abnormality (e.g., a patent foramen ovale
) could account for all gas sites observed.
Meier, "Paradoxical emboli through the patent foramen ovale
as the suspected cause of myocardial and renal infarction in a 48-year-old woman," Catheterization and Cardiovascular Interventions, vol.