ABSTRACT
In patients with appropriate anatomical dimensions of ASD, interventional closure should be favored. This technique provides low complication rates, a short hospitalization, and acceptable costs. Surgical ASD closure should be reserved for patients with septum primum defects, sinus venosus defects, or very large secundum defects. The significant coincidence of residual leak and recurrent embolic events suggests that PFO closure is the right way to prevent a patient with (cryptogenic) stroke and PFO from recurrences. However, randomized data are still lacking. In the last years, many new PFO devices with different approaches for stroke prevention have entered the market. There is a trend toward PFO specific devices that leave less or no foreign material in the heart to minimize device related complications. Percutaneous PFO closure can be performed safely with a high success rate and low morbidity. In observational studies, it has been shown to be effective in preventing recurrent cerebral ischemia in patients with a history of (cryptogenic) stroke.
