Pfo closure

In our desire to bring harmony to understanding of unexplained pathologies, we tend to relate commonly occurring entities and attempt to demonstrate meaningful association or causality. The foramen ovale is a universally present structure in utero, remaining patent in a substantial proportion of live births and through adulthood. In its commonness, it has been associated with many disease states and claims of causal inference. As we review the current state of best practice concerning patent foramen ovale (PFO) based on recent randomized controlled trials and practice guidelines, we are reminded that the human body, despite its medical frailties, remains an incredibly efficient machine; a decision to permanently alter its workings should demand knowledge gleaned from substantiated experience and validated data...

PURPOSE OF REVIEW: A comprehensive review of the main concepts about patent foramen ovale (PFO) management is offered. RECENT FINDINGS: PFO is a common, usually benign, anatomical variant that in the presence of a discrete right-to-left shunt and other predisposing factors (Eustachian valve/Chiari network, atrial septal aneurysm, and coagulation cascade abnormalities) may play an important role in the patho-physiology of paradoxical embolism at different levels (cryptogenic stroke, peripheral embolism, coronary embolism, etc...