Review
Version 1
Preserved in Portico This version is not peer-reviewed
All PFOs Should Be Closed
Version 1
: Received: 2 April 2024 / Approved: 2 April 2024 / Online: 3 April 2024 (08:11:39 CEST)
How to cite: Meier, B. All PFOs Should Be Closed. Preprints 2024, 2024040230. https://doi.org/10.20944/preprints202404.0230.v1 Meier, B. All PFOs Should Be Closed. Preprints 2024, 2024040230. https://doi.org/10.20944/preprints202404.0230.v1
Abstract
To date, the patent foramen ovale (PFO) does not get the deserved medical attention. The PFO poses a serious threat to health and even life of mankind. The first respective case report in the medical literature dates back to the 19th century. It led to death. The fact that a PFO is present in roughly 25% of people underscores its overall potential to do harm. Yet at the same time by the sheer number, it discourages the medical community from screening for it and from treating it. About 5% of the population have particularly dangerous forms of PFOs. Such PFOs portray a high enough risk for clinical events, the likes of death, stroke, myocardial infarction, or ocular, visceral, and peripheral embolism, to justify screening for them. Highly significant health incidents being at stake, it appears obvious that PFO closure should be used for primary prevention. This is supported by the fact that closing a PFO is the simplest intervention in cardiology, with presumably the highest clinical yield. Being mainly a preventive measure, PFO closure represents a mechanical vaccination. When closing PFOs for one of the rarer therapeutic indications (migraine, platypnea orthodeoxia, etc.), patients automatically profit from the collateral benefit of getting at the same time mechanically vaccinated for life against paradoxical embolism. Vice versa, closing a PFO for prevention of paradoxical embolism not infrequently betters or cures migraine or exercise dyspnea, thereby improving quality of life as a collateral benefit.
Keywords
Angina pectoris; atrial septal defect; collateral benefit; device closure; left atrial appendage; mechanical vaccination; migraine; myocardial infarction; patent foramen ovale; paradoxical embolism; peripheral embolism; primary prevention; stroke; transient ischemic attack
Subject
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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