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Cerebrovascular and cardiac events in patients with patent foramen ovale closure after stroke (Master thesis)

Σδρέβανος, Παναγιώτης/ Sdrevanos, Panagiotis

Stroke is a major cause of death and disability globally, with ischemic stroke (ICH) accounting for 80% of all cases. The diagnosis of a patient with IAHE, following treatment in the acute phase, also requires appropriate treatment as a secondary prevention to reduce the risk of recurrence. Appropriate management is indicated by the aetiology of IAHE in the individual patient. It is known that the aetiology of IAHE remains unclear in more than 1/3 of patients with IAHE at discharge. According to the TOAST etiological classification of IAHEs, an IAHE is classified as cryptogenic (CS) when a specific cause cannot be identified despite appropriate diagnostic investigation. The prevalence of Patent Foramen Ovale (PFO) in the general population is estimated to be 25-30%. Data from observational studies suggest a significant association between PFO (with or without the coexistence of an atrial septal aneurysm - ASA) and CS in young patients. However, data from observational studies and meta-analyses of these studies show conflicting results regarding the recurrence of IAH in patients with a closed PFO. There is also concern in the international medical community about the complications that arise after closure of the patent foramen ovale with any closure device. The risk of death immediately after treatment ('mortality rate') is very low, but, as several scientific studies have shown, complications from device closure are rare, but when they do occur, they are serious and often require urgent surgical treatment. Therefore, heeding the need to deepen this field of interest, this paper focuses on investigating the effects of open ovoid rupture closure in patients following a vascular stroke, examining the cerebrovascular and cardiac events.