Surgical Closure of Patent Foramen Ovale for Stroke Prevention: Vancouver General Hospital Experience
Bibliographic record
Abstract
95 Background and Purpose Patent foramen ovale (PFO) is implicated as a potential cause of stroke, particularly in young patients with otherwise cryptogenic events. The natural history, risk of stroke recurrence and optimal secondary stroke prevention remains uncertain. Therapeutic options include long-term antiplatelet therapy, anti-coagulation therapy, and PFO closure by surgery or device. We report the results of 53 patients treated with surgical closure. Methods and Materials We have followed 53 consecutive surgically treated patients (23 men and 30 female). All patients were evaluated by a stroke neurologist, a cardiologist with expertise in adult congenital disease and a cardiovascular surgeon. Patients who met the following criteria were included: 1) embolic TIA or stroke, 2) PFO or PFO and atrial septal aneurysm (ASA), 3) investigations included cerebral angiography, transesophageal echocardiography, and hypercoagulable studies, 4) presumptive clinical diagnosis of paradoxical embolism with no other etiology detected. Follow up was obtained by clinic visit and standardized telephone questionnaire. Results Prior to surgery 27 patients had stroke and 26 had TIAs; 12 had multiple cerebrovascular events. The mean age at symptom onset was 41.8 ± 9.3 yrs (range 19 to 59). 22 patients had an isolated PFO and 31 had both a PFO and an ASA. Average PFO size measured at surgery was 8.8 ± 7.7 mm. 40 were treated with primary closure, 13 with suture and patch closure. Average post-surgical hospital stay was 4 days. There was no surgical mortality or major morbidity. Minor perioperative morbidity occurred in 13 patients. Average follow up postsurgery was 22.2 ± 17.4 months (range 0.7 to 90.8 months). There were no recurrent strokes and 1 recurrent TIA. Conclusions Surgical closure of PFO can be safely performed with low morbidity and mortality. In this group of carefully selected patients, there have been no recurrent strokes. Further studies are necessary to define high-risk patients for recurrent stroke who may benefit from surgical closure.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".