Patent foramen ovale: percutaneous closure

With use of a femoral approach, a transvenous sheath is advanced across the foramen into the left atrium, where a folded disk is expanded and pulled back, opposing the primum and secundum septa closed. This step is followed by deployment of a right-sided disk, at which time the 2-disk device is released. Clopidogrel and aspirin are recommended for a period of 3 months to prevent thrombus formation on the device, with aspirin therapy continued for an additional 3 months, when endothelialization is complete. Antibiotic prophylaxis for 6 months is recommended. Complete late closure of the foramen has been reported in 80% to 95% of patients. (Reproduced with permission from: Kizer JR, Devereux RB. Clinical practice. Patent foramen ovale in young adults with unexplained stroke. N Engl J Med 2005;353:2361-72. Copyright 2005 Massachusetts Medical Society. All rights reserved.)