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Patients with congenital pulmonic stenosis who present in late adolescence or adult life can be treated with percutaneous balloon valvuloplasty with excellent short-term and long-term results that are similar to those in young children.

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp atent foramen ovale (PFO) is an anatomical variant of the interatrial septum with an overall prevalence of 27% in autopsy studies. 1 PFO has been associated with cryptogenic stroke and migraine headaches, 2-4 and increasingly recognized as a source of paradoxical embolism. A high prevalence of PFO has been reported in approximately 50% of patients with cryptogenic transient ischemic attack (TIA) or ischemic stroke, 2 suggesting an association between the presence of PFO, with or without atrial septal aneurysm (ASA), and thromboembolic events (TE). 5 The optimal management for the prevention of a paradoxical embolic event in these patients remains controversial. Medical therapies with anticoagulants or antiplatelet agents, surgical PFO closure and percutaneous transcatheter closure of the PFO have been proposed as therapeutic options. 6 The results of several randomized clinical trials, randomized controlled trials and reports of single-center experience have indicated that transcatheter PFO closure is a potential option for patients with PFO and thromboembolic phenomena, in that it avoids the morbidity associated with surgical closure or lifelong anticoagulation therapy. 4,7-10 Despite the good short-term results of transcatheter PFO closure in these patients, however, the long-term data are limited, especially in Chinese patients. The aim of the present study was therefore to assess the long-term clinical outcome in PFO patients with paradoxical embolism who underwent transcatheter PFO closure in a single center. Methods PatientsBetween January 2005 and May 2010, 192 patients who were referred for transcatheter closure of a PFO following 1 or more presumed paradoxical systemic events were included in the present study. A TE was considered to be due to a paradoxical embolism when the following criteria were met: presence of PFO with spontaneous or provocable right-to-left shunt during transthoracic echocardiography (TTE)/trans-

This prospective study provides a feasible method to prove that transthoracic echocardiography can visualize clearly and identify accurately the exact site of each pulmonary vein. The information should be helpful to study various pulmonary venous diseases.

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