Association between acute myocardial infarction and death in 386 patients with a thrombus straddling a patent foramen ovale

Shah, Palak; Jiménez‐Ruiz, Amado; Gibson, Andrew; Vargas‐González, Juan Camilo; Bres-Bullrich, Maria; Bagur, Rodrigo; Sposato, Luciano A.

doi:10.1016/j.ijcard.2021.07.007

Cited by 6 publications

(10 citation statements)

References 24 publications

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“…The concept of paradoxical embolism was first described in 1877 10 and is mechanistically demonstrated by a high incidence of clinically manifest ischemic stroke in patients found to have a thrombus straddling a PFO. 11 In patients with PFO, a thrombus that develops in the systemic venous circulation may bypass lung filtration and cross directly into the cerebral arterial circulation causing a paradoxical arterial stroke. Given the mean diameter of persisting PFOs is 9.9 mm, thrombi traversing the PFO are often large enough to occlude the middle cerebral artery (3 mm) or its cortical branches (1 mm).…”

Section: Patent Foramen Ovale Epidemiology Stroke Mechanisms and High...mentioning

confidence: 99%

Patent Foramen Ovale Management for Secondary Stroke Prevention: State-of-the-Art Appraisal of Current Evidence

Sposato,

Albin,

Elkind

et al. 2024

Stroke

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Patent foramen ovale (PFO) is frequently identified in young patients with ischemic stroke. Randomized controlled trials provide robust evidence supporting PFO closure in selected patients with cryptogenic ischemic stroke; however, several questions remain unanswered. This report summarizes current knowledge on the epidemiology of PFO-associated stroke, the role of PFO as a cause of stroke, and anatomic high-risk features. We also comment on breakthrough developments in patient selection algorithms for PFO closure in relation to the PFO-associated stroke causal likelihood risk stratification system. We further highlight areas for future research in PFO-associated stroke including the efficacy and safety of PFO closure in the elderly population, incidence, and long-term consequences of atrial fibrillation post-PFO closure, generalizability of the results of clinical trials in the real world, and the need for assessing the effect of neurocardiology teams on adherence to international recommendations. Other important knowledge gaps such as sex, race/ethnicity, and regional disparities in access to diagnostic technologies, PFO closure devices, and clinical outcomes in the real world are also discussed as priority research topics.

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Section: Patent Foramen Ovale Epidemiology Stroke Mechanisms and High...mentioning

confidence: 99%

Patent Foramen Ovale Management for Secondary Stroke Prevention: State-of-the-Art Appraisal of Current Evidence

Sposato,

Albin,

Elkind

et al. 2024

Stroke

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“…Only recently was the first documented case of percutaneous thromboembolectomy of a TSFO documented 3 . Since its publication, new studies have demonstrated that right atrial thrombectomy of TSFO is associated with a 65% decrease in‐hospital mortality 2 . These studies have not yet expanded on the effect percutaneous thrombectomy may have on patients with TSFO.…”

Section: Introductionmentioning

confidence: 99%

“…Since 1950, only 386 cases of TSFO have been documented. 2 The propensity for segments of the clot to embolize to cerebral, renal, and intestinal circulation account for the high morbidity and mortality in these patients. Previously, the management of TSFO has been with surgery, thrombolysis, or anticoagulation.…”

Section: Introductionmentioning

confidence: 99%

“…Even more rare is a thrombus straddling a patent foramen ovale (TSFO). Since 1950, only 386 cases of TSFO have been documented 2 . The propensity for segments of the clot to embolize to cerebral, renal, and intestinal circulation account for the high morbidity and mortality in these patients.…”

Section: Introductionmentioning

confidence: 99%

“…3 Since its publication, new studies have demonstrated that right atrial thrombectomy of TSFO is associated with a 65% decrease in-hospital mortality. 2 These studies have not yet expanded on the effect percutaneous thrombectomy may have on patients with TSFO. Given the rarity of this event and therefore the lack of consensus on treatment, we report a case series that explores novel treatment techniques of TSFO.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Thrombi straddling patent foramen ovale: A case series with various management strategies

Gill

Keeling

Thames

2022

Cathet Cardio Intervent

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Congenital heart disease: types, pathophysiology, diagnosis, and treatment options

Meng,

Song,

Zhang

et al. 2024

MedComm

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Congenital heart disease (CHD) is a structural abnormality of the heart and/or great vessels and patients with CHD are at an increased risks of various morbidities throughout their lives and reduced long‐term survival. Eventually, CHD may result in various complications including heart failure, arrhythmias, stroke, pneumonia, and sudden death. Unfortunately, the exact etiology and pathophysiology of some CHD remain unclear. Although the quality of life and prognosis of patients with CHD have significantly improved following technological advancement, the influence of CHD is lifelong, especially in patients with complicated CHD. Thus, the management of CHD remains a challenge due to its high prevalence. Finally, there are some disagreements on CHD among international guidelines. In this review, we provide an update of the pathophysiology, diagnosis, and treatment in most common type of CHD, including patent foramen ovale, atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosus, coarctation of the aorta, transposition of the great arteries, congenitally corrected transposition of the great arteries, coronary anomalies, left and right ventricular outflow tract obstruction, tetralogy of Fallot and Ebstein anomaly. In particular, we focus on what is known and what is unknown in these areas, aiming to improve the current understanding of various types of CHD.

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Association between acute myocardial infarction and death in 386 patients with a thrombus straddling a patent foramen ovale

Cited by 6 publications

References 24 publications

Patent Foramen Ovale Management for Secondary Stroke Prevention: State-of-the-Art Appraisal of Current Evidence

Patent Foramen Ovale Management for Secondary Stroke Prevention: State-of-the-Art Appraisal of Current Evidence

Thrombi straddling patent foramen ovale: A case series with various management strategies

Congenital heart disease: types, pathophysiology, diagnosis, and treatment options

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