How Big Is A Patent Foramen Ovale & What Are The Coping Methods For It?

Patent Foramen Ovale diameters vary between 1-19 mm in autopsy and studies show that PFO sizes are larger in adults.1

A large-sized PFO is approximately 2mm or more in septal separation and this has been identified in several patients experiencing embolic strokes.2

Coping methods of Patent foramen ovale include treatment through antiplatelet medicines or procedures such as a catheter-based procedure or PFO closure during heart surgery.3, 4

How Big Is A Patent Foramen Ovale?

Patent foramen ovale plays a crucial role in normal fetal circulation. Normally the blood flows through the major pulmonary arteries usually from the right atrium to the left atrium. The size of the PFO’s is often determined during autopsies. A study was conducted on 965 autopsy specimens of the human heart. These patients were of random age groups and sex.1

The study demonstrated that there was no significant difference either in the size or incidence between the different subjects. However, the overall incidence decreased over the decades

Decades Incidence
Overall 27.3%
First three decades 34.3%
4th -8th decades 25.4%
9th -10th decades 20.2 %

Among these specimens, the size of the Patent foramen ovale varied between 1-19mm with a maximum potential diameter of 4.9mm.

However, in most PFO patients the foramen ovale was between 1-10mm in diameter. The study concluded that the size of the foramen ovale increased with age, the first decade had a mean of 3.4mm size whereas the 10th decade recorded a mean of 5.8mm.

The size of the Patent foramen ovale is typically measured by transthoracic echocardiography, TEE, or by transcranial Doppler ultrasonography based on several aspects. 2

What Are The Coping Methods For Patent Foramen Ovale?

When there are symptoms or if the patient has a history of cardiovascular problems, your healthcare provider may suggest PFO closure. Patent foramen ovale left untreated may sometimes cause transient ischemic stroke and paradoxical embolism. Although most closures are technically successful with a success rate of 86% yet procedure-related complications were identified in 3.2% of cases resulting in a higher risk of recurrence. So PFO closure with negative results requires coping methods.

The German news release from St. Jude Medical supported and favored Amplatzer PFO Occluder instead of just medical therapy for Patent foramen ovale closures. This can significantly prevent or reduce the risk of recurrent strokes. Also, the Department of Cardiology stated that closure can be performed in an outpatient setting and doesn’t require anesthesia. This was perhaps having a low level of risk and the individuals were able to proceed with the sports activity immediately thereafter.

A meta-analysis, as well as a pooled analysis, were undertaken after every new study regardless of the difference in population, incidence, and complications. Based on the analysis and approval by the Food and Drug Administration Amplatzer PFO Occluder System was clinically approved as a successful tool for coping with the PFO closure.3, 4

A hole in the heart is a real definition of the problem. Nearly a quarter of the population worldwide is identified with some kind of heart disease and Patent foramen ovale is one the most common heart defect identified soon after birth. As this disorder produces no signs or symptoms many patients don’t even realize that they have this condition

Patent foramen ovale occurs post-birth when the foramen ovale fails to close. The foramen ovale is an aperture in the muscular tissue between the left and right atrium of every human fetus. It usually closes 6 months to a year after the baby’s birth.

References:

  1. Kutty, Shelby, et al. “Patent Foramen Ovale: The Known and the To Be Known.” Journal of the American College of Cardiology, Elsevier, 30 Apr. 2012, www.sciencedirect.com/science/article/pii/S0735109712007590.
  2. Alibegovic, J, et al. “The Role of the Sizing Balloon in Selection of the Patent Foramen Ovale Closure Device Size.” Experimental and Clinical Cardiology, Pulsus Group Inc, 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2435395/.
  3. Rosselló Ferrer, Ainhoa, et al. “Patent Foramen Ovale and Mechanical Ventilation.” Revista Española De Cardiología (English Edition), Elsevier, 1 July 2010, www.revespcardiol.org/en-patent-foramen-ovale-mechanical-ventilation-articulo-13154121.
  4. “9. Cardiac Issues in Individuals with Stroke.” Canadian Stroke Best Practices, www.strokebestpractices.ca/recommendations/secondary-prevention-of-stroke/cardiac-issues-in-individuals-with-stroke.

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