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Prognosis After Stroke Followed by Surgical Closure of Patent Foramen Ovale Neurol 47:1162-1166, Devuyst,G.,et al, 1996 See this aricle in Pubmed Article Abstract All patients had a direct suture of PFO while under cardiopulmonary bypass without recorded early or delayed significant complication.All patients underwent a new brain MRI and TEE simultaneous with transcranial Doppler ultrasonography after contrast injection at 8+/-3 months after surgery. After a mean follow-up of 2 years without antithrombotic treatment,no recurrent cerebrovascular event(stroke or transient ischemic attack[TIA]) and no new lesion on MRI had developed.Postoperative contrast TEE and transcranial Doppler ultrasonography showed that two patients had residual interatrial right-to-left shunting,although much smaller than before surgery,associated with single versus double continuous suture.Our study of 30 selected stroke patients with surgical suture of PFO showed a stroke recurrence rate of 0%and no significant complication.Residual right-to- left shunting may be avoided by double continuous suture of the PFO.In the absence of controlled studies to guide individual therapeutic decisions, our findings show that PFO closure can be done safely and may be considered to avoid recurrence in selected patients with long life expectancy and presumed paradoxic embolism.

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