Patent Foramen Ovale Clinical Practice Guidelines (SCAI, 2022)

Clinical practice guidelines on the management of patent foramen ovale (PFO) from the Society for Cardiovascular Angiography and Interventions (SCAI) were published in May 2022 in JSCAI.^[1]

In patients aged 18-60 years who have had a PFO-related stroke, PFO closure is strongly recommended instead of antiplatelet therapy alone.

For patients aged 60 years and older with a history of PFO-related stroke, PFO closure is conditionally suggested rather than long-term antiplatelet therapy alone.

The SCAI guidelines conditionally suggest PFO closure rather than long-term antiplatelet therapy alone for patients with thrombophilia who have had a PFO-related stroke and are already receiving antiplatelet therapy but are not on anticoagulation.

PFO closure is suggested for patients with platypnea-orthodeoxia syndrome who have no other identifiable cause of hypoxia.

For patients with systemic embolism in whom other embolic causes have been ruled out, PFO closure is suggested instead of medical therapy alone.

For persons with thrombophilia who have not had a PFO-related stroke, the SCAI guidelines advise against the routine use of PFO closure.

The guidelines conditionally advise against PFO closure in patients with atrial fibrillation who have had an ischemic stroke.

The routine use of PFO closure is not recommended for the treatment of migraine in patients with chronic migraine who have not had a PFO-related stroke.

For scuba divers with a history of decompression illness (DCI) who have not had a PFO-related stroke, the routine use of PFO closure to prevent DCI is not recommended.

The SCAI guidelines also advise against the routine use of PFO closure in patients with a history of atrial septal aneurysm, transient ischemic attack, or deep vein thrombosis who have not had a PFO-related stroke.

For more information, please go to Patent Foramen Ovale.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Patent Foramen Ovale Clinical Practice Guidelines (SCAI, 2022) - Medscape - May 27, 2022.

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