Sign Up for a Free Account

This is an image preview.
Start a Free Account
to view the full image.

Sign Up for a Free Account For information on discounts, see Plans & Pricing

  • Nearly 3,000 illustrations, including video clips of neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of neurology in 1,200 comprehensive articles.

  • Listen to MedLink on the go with Audio versions of each article.

Patent foramen ovale: percutaneous closure

With use of a femoral approach, a transvenous sheath is advanced across the foramen into the left atrium, where a folded disc is expanded and pulled back, opposing the primum and secundum septa closed. This step is followed by deployment of a right-sided disc, at which time the 2-disc device is released. Clopidogrel and aspirin are recommended for a period of 3 months to prevent thrombus formation on the device, with aspirin therapy continued for an additional 3 months, until endothelialization is complete. However, a study looking at markers of platelet activation and activation of the coagulation system in patients with cryptogenic stroke who underwent transcatheter closure of their patent foramen ovales found that there was enhanced thrombogenesis and not platelet activation and, thus, recommended the use of anticoagulation as opposed to antiplatelet agents for the short-term (Bedard et al 2007). Antibiotic prophylaxis for 6 months is recommended. Complete late closure of the foramen has been reported in 80% to 95% of patients. (Reproduced with permission from: Kizer JR, Devereux RB. Clinical practice. Patent foramen ovale in young adults with unexplained stroke. N Engl J Med 2005;353:2361-72. Copyright 2005 Massachusetts Medical Society. All rights reserved.)

Related Article

Related Media

Associated Disorders

  • Atrial myxoma
  • Atrial septal aneurysm
  • Atrial septal defect
  • Cryptogenic stroke
  • Embolic stroke
  • Fat embolism
  • Ischemic stroke
  • Neurologic decompression illness
  • Obstructive sleep apnea
  • Papillary fibroelastoma
  • Paradoxical embolism
  • Platypnea-orthodeoxia syndrome
  • Pulmonary embolism
  • Pulmonary hypertension
  • Right heart failure
  • Thromboembolism
  • Transient ischemic attack
  • Tumor embolism
  • Venous thrombosis