Can RESPECT extended follow-up results end controversy of patent foramen ovale interventional therapy?

The RESPECT trial is a randomized clinical trial investigating the safety and efficacy of transcatheter patent foramen ovale (PFO) closure using the Amplatzer PFO occluder (St. Jude Medical, Inc., St. Paul, MN) in the secondary prevention of recurrent cryptogenic stroke vs. medical management. Results of the preliminary study were published in the New England Journal of Medicine in 2013, which showed that there was no significant difference in the prevention of cryptogenic stroke between transcatheter closure of PFO and drug treatment. During the Transcatheter Cardiovascular Therapeutics Conference in the United States (October 15, 2015), the extended follow-up results of the RESPECT study were announced and the results showed that Amplatzer PFO Occluder was superior to medical management in reducing recurrent cryptogenic ischemic stroke. This article explains the main content along with recent and long-term results of the RESPECT study and presents the author’s evaluation.