Das offene Foramen ovale: Sekundärprävention paradoxer Embolien

The foramen ovale, a survival from the foetal circulation, remains patent in approx. 25% of the population, in whom it renders possible an intracardiac right-left shunt during the (short) periods when right atrial exceeds left atrial pressure. In recent times patent foramen ovale (PFO) has come to the fore as a possible cause of disease syndromes, particularly paradoxical embolism and neurological decompression illness in divers. The optimum therapeutic strategy in the patients affected is still unknown. This paper discusses the therapeutic options for prevention of recurrent embolic events, comprising both drug therapy and surgical or percutaneous PFO closure.