This manuscript will focus on a rare complication: shunting through a patent foramen ovale (PFO) as a long term complication of right sided pneumonectomy or bilobectomy. Three patients who were diagnosed with shunting through a patent foramen ovale following lung resection are described. In these patients right ventricular compression by the elevated right hemidiaphragm was the cause of shuntin...

Previous randomized trials on patent foramen ovale (PFO) Background: closure versus medical therapy for stroke prevention were inconclusive. Recently, two new randomized trials and new findings from an extended follow-up of a previous trial have been published on this topic. We conducted a systematic review and meta-analysis of randomized trials comparing PFO closure with medical therapy for st...

Isolated hand paresis is a rare presentation of stroke, which mostly results from a lesion in the cortical hand motor area, a knob-like area within the precentral gyrus. I report the case of a patient who experienced recurrent ischemic stroke alternately involving bilateral hand knob areas, causing isolated hand paresis. There was no abnormal finding on brain and neck magnetic resonance angiogr...

Migraine is a neurological disorder characterized by an increased individual susceptibility to respond to certain triggers by a propagating wave of neuronal depolarization that culminates in typical migraine headaches. Patients with a patent foramen ovale or any kind of right-to-left shunt are more likely to have migraine; and patients with migraine with aura are more likely to have a patent fo...

BACKGROUND Patent foramen ovale as a possible stroke risk factor can be diagnosed with transcranial Doppler sonography (TCD) by detecting intravenous contrast medium crossing from the right to the left atrium. The present study evaluates the reliability of this method. SUMMARY OF REPORT We performed TCD and transesophageal echocardiography simultaneously in 50 patients using galactose microbu...

R ECENTLY two cases of pulmonary infarction were encountered which showed atypical clinical manifestations. At autopsy, in each instance a thrombus was found straddling a patent foramen ovale, suggesting a functional shunt during life. It is the purpose of this paper to describe the associated syndrome. Although some 48 instances of a clot caught in a patent foramen ovale have been described si...

An endovascular device to close a patent foramen ovale: b

OBJECTIVE Percutaneous transcatheter occlusion has benefited thousands of patients suffering from patent foramen ovale and atrial septal defect. However, no general agreement has been reached on the superiority among occluders. Thus, a meta-analysis between the two most commonly adopted types of occluders was conducted. METHODS The literature review has identified relevant studies up to May, ...

BACKGROUND The options for secondary prevention of cryptogenic embolism in patients with patent foramen ovale are administration of antithrombotic medications or percutaneous closure of the patent foramen ovale. We investigated whether closure is superior to medical therapy. METHODS We performed a multicenter, superiority trial in 29 centers in Europe, Canada, Brazil, and Australia in which t...

BACKGROUND Noninvasive positive pressure ventilation is frequently prescribed to obese patients with obstructive sleep apnea syndrome and obesity hypoventilation syndrome. However, mechanical ventilation with a positive end-expiratory pressure can induce or worsen a right-to-left shunt through a patent foramen ovale associated with systemic hypoxemia. Thus, in obese patients treated with noninv...