Single-center experience of multidisciplinary assessment of patent foramen ovale in elderly patients and follow-up after device closure

  AIM  To explore the safety and efficacy of transcatheter patent foramen ovale (PFO) occlusion in the treatment of high-risk PFO in the elderly patients on the basis of multidisciplinary evaluation.

  METHODS  Included in this study were the elderly patients admitted to our department from March 2014 to December 2020, who were diagnosed as having embolic strokes of undetermined source or transient ischemic attack (TIA) with high-risk PFO and received PFO closure. All the patients underwent multidisciplinary evaluation before the operation to rule out stroke/TIA that had a clear cause or other possible factors and after the operation the patients were followed up for complications and recurrent ischemic events.

  RESULTS  A total of 122 patients were enrolled (average age of 64(5)years) with mean follow-up time of 2.5±1.7 years. Two kinds of occluders were used in the study and there was no difference in the endpoint events between the two occluders and no serious adverse events occurred. The annual risk of recurrent ischemic stroke/TIA after PFO closure in elderly patients was 0.67%.

  CONCLUSION  It is safe and effective for high-risk elderly PFO patients to undergo transcatheter PFO closure after strict multidisciplinary evaluation. Such patients can be treated with percutaneous patent foramen ovale occlusion to prevent recurrence of cerebrovascular events.