Relationship between patent foramen ovale anatomical features and residual shunt after patent foramen ovale closure

Residual shunt after patent foramen ovale closure: The devil is in the details!

“…2 Focusing on the procedure, highly dependent on the operator's experience, patients included in the study either received the smallest or the largest size of the Amplatzer Occluder. 1 The median size, generally more suitable for a wider range of anatomies, was not deployed as expected, potentially influencing the outcomes. Furthermore, a significant proportion of patients received an Amplatzer Occluder for ASD closure (Amplatzer Cribriform).…”

“…To the Editor, We have to congratulate Nakayama et al 1 for their study focusing on residual shunting following patent foramen ovale (PFO) closure.…”

“…Moreover, no association was observed between residual shunt and PFO size, length of PFO tunnel, or size of the closure device employed. 1 We have to stress that the increased mobility of the atrial septum is frequently linked to the existence of additional atrial septal defects (ASDs) in areas of septum primum challenging to visualize through transesophageal echocardiography.…”

“…Finally, the study has not fully reported the anatomic factors strongly correlated with the presence of more severe residual shunts. 1 Are there specific high-risk PFO morphological features contributing to the occurrence of them? Therefore, a more detailed delineation of the PFO anatomy along with the evolution of residual shunts would be useful since as we all know in life and in medicine, the devil is in the details.…”