This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2005.08.038v1 46/9/1768    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (40) Citing Articles via Google Scholar Google Scholar Articles by Hara, H. Articles by Schwartz, R. S. Search for Related Content PubMed PubMed Citation Articles by Hara, H. Articles by Schwartz, R. S.

EXPEDITED REVIEW: STATE-OF-THE-ART PAPER

Patent Foramen Ovale: Current Pathology, Pathophysiology, and Clinical Status

Hidehiko Hara, MD^_*, Renu Virmani, MD, Elena Ladich, MD, Shannon Mackey-Bojack, MD, Jack Titus, MD, Mark Reisman, MD, William Gray, MD, Masato Nakamura, MD^||, Michael Mooney, MD^_*, Anil Poulose, MD^_* and Robert S. Schwartz, MD^_*,_*

^_* Minneapolis Heart Institute and Foundation, Minneapolis, Minnesota
CV Path, International Registry of Pathology, Gaithersburg, Maryland
Jesse E. Edwards Registry of Cardiovascular Disease, St. Paul, Minnesota
Swedish Medical Center, Seattle, Washington
^|| Division of Cardiovascular Medicine, Toho University Ohashi Hospital, Tokyo, Japan.

Manuscript received May 15, 2005; revised manuscript received June 16, 2005, accepted August 1, 2005.

^_* Reprint requests and correspondence: Dr. Robert S. Schwartz, Minnesota Cardiovascular Research Institute, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 620, Minneapolis, Minnesota. (Email: rss{at}rsschwartz.com).

Patent foramen ovale (PFO) is experiencing increased clinical interest as a congenital cardiac lesion persisting into adulthood. It is implicated in several serious clinical syndromes, including stroke, myocardial infarction, and systemic embolism. The PFO is now amenable to percutaneous interventional therapies, and multiple novel technologies are either available or under development for lesion closure. The PFO should be better understood to take advantage of emerging percutaneous treatment options. This paper reviews PFO anatomy, pathology, pathophysiology, and clinical impact and discusses current therapeutic options.

Abbreviations and Acronyms   ASA = atrial septal aneurysm   ASD = atrial septal defect   DCS = decompression sickness   INR = international normalized ratio   MRI = magnetic resonance imaging   PFO = patent foramen ovale   TCD = transcranial Doppler   TEE = transesophageal echocardiography   TIA = transient ischemic attack   TTE = transthoracic echocardiography

This article has been cited by other articles:

				S. C. Krishnan and M. Salazar Septal Pouch in the Left Atrium: A New Anatomical Entity With Potential for Embolic Complications J. Am. Coll. Cardiol. Intv., January 1, 2010; 3(1): 98 - 104. [Abstract] [Full Text] [PDF]

				L. Galiuto, S. Giubilato, A. R De Caterina, A. Porfidia, C. Colizzi, A. Sestito, I. Porto, C. Trani, A. G Rebuzzi, and F. Crea Patent foramen ovale and hypercoagulable state in the pathogenesis of acute thrombotic myocardial infarction BMJ Case Reports, July 23, 2009; 2009(jul23_1): bcr1120081211 - bcr1120081211. [Abstract] [Full Text]

				A. Undas, P. Podolec, K. Zawilska, M. Pieculewicz, I. Jedlinski, E. Stepien, E. Konarska-Kuszewska, P. Weglarz, M. Duszynska, E. Hanschke, et al. Altered Fibrin Clot Structure/Function in Patients With Cryptogenic Ischemic Stroke Stroke, April 1, 2009; 40(4): 1499 - 1501. [Abstract] [Full Text] [PDF]

				M. J Earley How to perform a transseptal puncture Heart, January 1, 2009; 95(1): 85 - 92. [Full Text] [PDF]

				Y. J. Kim, J. Hur, C.-Y. Shim, H.-J. Lee, J.-W. Ha, K. O. Choe, J. H. Heo, E.-Y. Choi, and B. W. Choi Patent Foramen Ovale: Diagnosis with Multidetector CT--Comparison with Transesophageal Echocardiography1 Radiology, January 1, 2009; 250(1): 61 - 67. [Abstract] [Full Text] [PDF]

				Y. J. Kim, J. Hur, C.-Y. Shim, H.-J. Lee, J.-W. Ha, K. O. Choe, J. H. Heo, E.-Y. Choi, and B. W. Choi Patent Foramen Ovale: Diagnosis with Multidetector CT--Comparison with Transesophageal Echocardiography Radiology, November 10, 2008; (2008) 2501080559. [Abstract] [Full Text]

				M. R. Sukernik and E. Bennett-Guerrero The Incidental Finding of a Patent Foramen Ovale During Cardiac Surgery: Should It Always Be Repaired? A Core Review Anesth. Analg., September 1, 2007; 105(3): 602 - 610. [Abstract] [Full Text] [PDF]

				J. Tang and J. J. Weiter Branch Retinal Artery Occlusion after Injection of a Long-Acting Risperidone Preparation Ann Intern Med, August 21, 2007; 147(4): 283 - 284. [Full Text] [PDF]

				H. Hara, T. K. Jones, E. R. Ladich, R. Virmani, D. C. Auth, J. E. Eichinger, R. J. Sommer, R. A. Van Tassel, and R. S. Schwartz Patent Foramen Ovale Closure by Radiofrequency Thermal Coaptation: First Experience in the Porcine Model and Healing Mechanisms Over Time Circulation, August 7, 2007; 116(6): 648 - 653. [Abstract] [Full Text] [PDF]

				M. Schwerzmann and B. Meier Patent Foramen Ovale and Stroke Risk: The Devil Is in the Detail J. Am. Coll. Cardiol., July 3, 2007; 50(1): 80 - 80. [Full Text] [PDF]

				N. Botto, I. Spadoni, S. Giusti, L. Ait-Ali, R. Sicari, and M. G. Andreassi Prothrombotic Mutations as Risk Factors for Cryptogenic Ischemic Cerebrovascular Events in Young Subjects With Patent Foramen Ovale Stroke, July 1, 2007; 38(7): 2070 - 2073. [Abstract] [Full Text] [PDF]