UMEM Educational Pearls

Category: Cardiology

Title: Patent Foramen Ovale: To Close or Not to Close

Keywords: Patent Foramen Ovale (PubMed Search)

Posted: 11/23/2014 by Semhar Tewelde, MD (Updated: 2/5/2023)
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Patent Foramen Ovale: To Close or Not to Close

- Patent foramen ovale (PFO) is associated with a 3-fold increased risk for recurrent stroke, yet current guidelines only recommends “consideration” of PFO closure after a second cryptogenic stroke.

- Studies have demonstrated reductions in recurrent neurologic events with transcatheter PFO closure compared with medical therapy alone.

- Until recently the cost-effectiveness of PFO closure has not been described.

- Although PFO closure was found to be immediately more costly per patient closure, it reached cost-effectiveness at ~2.5 years of follow-up.

- Closure of PFO is both beneficial in terms of risk-benefit and cost-effectiveness strategy, especially as cryptogenic stroke typically affects the young.

References

Pickett C, Villines T, Ferguson M, et al. Cost Effectiveness of Percutaneous Closure Versus Medical Therapy for Cryptogenic Stroke in Patients With a Patent Foramen Ovale. The American Journal of Cardiology. Volume 114, Issue 10, Pages 1584-89 (15 November 2014)