INDICATIONS FOR THE CLOSURE OF PATENT FORAMEN OVALE

摘要

The foramen ovale, while vital to our formative development, assumes mischievous potential if it persists post-utero. Similar to other vestigial structures, presence of a patent foramen ovale (PFO) appears to carry no physiologic or survival benefit for normal individuals. In states of abnormal right sided cardiac or pulmonary vascular capacitance or resistance, PFO has been implicated in worsening hypoxaemia caused by right to left intracardiac passage of deoxygenated blood (see box). More recently, a causative role of PFO in much more commonly occurring syndromes, including embolic ischaemic stroke, migraine with aura, and cerebral and cutaneous decompression disease, has been suggested. Highlighting cryptogenic embolic stroke associated with PFO, we will systematically review the evidence for these relations, discuss therapeutic potentials, and propose guidelines for therapeutic decisions as we await the completion of randomised controlled interventional trials.