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World J Cardiol. Jun 26, 2015; 7(6): 326-330
Published online Jun 26, 2015. doi: 10.4330/wjc.v7.i6.326
Closing patent foramen ovale in cryptogenic stroke: The underscored importance of other interatrial shunt variants
Gianluca Rigatelli, Alberto Rigatelli
Gianluca Rigatelli, Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, 45100 Rovigo, Italy
Alberto Rigatelli, Urgency Medicine, Verona University Medical School, 37045 Verona, Italy
Author contributions: Rigatelli G designed research; Rigatelli G and Rigatelli A performed research; Rigatelli A contributed new reagents or analytic tools; Rigatelli G wrote the paper.
Conflict-of-interest: None of the authors has conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gianluca Rigatelli, MD, PhD, Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Viale Tre martiri, 45100 Rovigo, Italy. jackyheart71@yahoo.it
Telephone: +39-347-1912016 Fax: +39-425-394513
Received: January 29, 2015
Peer-review started: January 29, 2015
First decision: March 6, 2015
Revised: March 13, 2015
Accepted: April 16, 2015
Article in press: April 20, 2015
Published online: June 26, 2015
Processing time: 146 Days and 23.5 Hours
Core Tip

Core tip: Recent trials and met analysis suggested that mechanical device-based closure of patent foramen ovale (PFO) is more effective than medical therapy in prevent recurrence of stroke. Fenestrated atrial septal aneurysms and small atrial septal defects (hybrid defects) can present with signs of paradoxical embolism and because they are often not clearly differentiable by standard diagnostic tools, it is likely that a proportion of patients evaluated for transcatheter closure of PFO, had actually a different anatomical substrate. These different anatomical entities have not been address in any of the previous trials, potentially having an impact on overall results.