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From the Departments of Cardiology (Drs. Wahl, Meier, Seiler, and Windecker), and Neurology (Drs. Nedeltchev, Arnold, Eicher, Sturzenegger, and Mattle), University Hospital Bern, Switzerland.
Address correspondence and reprint requests to Dr. Stephan Windecker, Cardiology, Swiss Cardiovascular Center Bern, University Hospital, CH-3010 Bern, Switzerland; e-mail: stephan.windecker{at}insel.ch
The long-term risk and risk factors for recurrent embolism after percutaneous closure of patent foramen ovale (PFO) were investigated in 152 consecutive patients with presumed paradoxical embolism. During follow-up, the actuarial freedom from recurrent embolism was 95.1% at 1 year, and 90.6% at 2 and 6 years. A residual shunt after percutaneous PFO closure was a predictor for recurrence (RR 5.3; 95% CI 1.3 to 21.0; p = 0.02). Randomized trials comparing medical treatment with percutaneous PFO closure in the prevention of recurrent embolism are in progress.
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