TY - CHAP M1 - Book, Section TI - Atrial Septal Defect & Patent Foramen Ovale A1 - Bashore, Thomas M. A1 - Granger, Christopher B. A1 - Jackson, Kevin P. A1 - Patel, Manesh R. A2 - Papadakis, Maxine A. A2 - McPhee, Stephen J. A2 - Rabow, Michael W. A2 - McQuaid, Kenneth R. PY - 2022 T2 - Current Medical Diagnosis & Treatment 2022 AB - Key Clinical Updates in Atrial Septal Defect & Patent Foramen OvaleThe 2020 ESC guidelines add the PVR to their criteria and consider it a class IIa indication if the PVR is between 3 Wood units and 5 Wood units, and the guidelines preclude the use of closure if the PVR is ≥ 5 Wood units.ESC guidelines favor bringing the patient back to the catheterization laboratory for retesting on pulmonary vasodilators, rather than using acute testing, to see if the PVR can be reduced below 5 Wood units.The ESC guidelines also suggest considering fenestrated closure in the face of pulmonary hypertension.The use of bosentan or sildenafil is recommended if the PVR is over 5 Wood units and there is a right to left shunt.A 2020 update from the guideline subcommittee of the American Academy of Neurology reaffirms no change in the policy that states patients < 55 years with cryptogenic stroke/TIA and no other identifiable cause except for the presence of a PFO should still be considered for PFO closure.The presence of a “floppy atrial septum - atrial septal aneurysm” has been associated with a higher risk of recurrent stroke/TIA in patients with cryptogenic stroke/TIA. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1184695050 ER -