RT Book, Section
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.
SR Print(0)
ID 1184695050
T1 Atrial Septal Defect & Patent Foramen Ovale
T2 Current Medical Diagnosis & Treatment 2022
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264269389
LK accessmedicine.mhmedical.com/content.aspx?aid=1184695050
RD 2024/04/16
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.