Abstract
A case of unusual atrial septal anatomy with right-to-left shunting in a patient with cryptogenetic cerebral ischemia is presented. Percutaneous correction and technical tips are described.
Highlights
The appropriate treatment strategy for secondary stroke prevention in patients with cryptogenic stroke and Patent Foramen Ovale (PFO) remains challenging
This report deals with a patient with trans-cranial Doppler positivity and non-apparent PFO with initial impossibility to cross the atrial septum during PFO percutaneous closure attempts
TTE had confirmed the presence of right to left shunt at atrial septum level, according to a positivity of Trans-Cranial Doppler (TCD) with curtain effect during Valsalva maneveur
Summary
The appropriate treatment strategy for secondary stroke prevention in patients with cryptogenic stroke and Patent Foramen Ovale (PFO) remains challenging. A case of unusual atrial septal anatomy with right-to-left shunting in a patient with cryptogenetic cerebral ischemia is presented. The clinical and anatomic variables reported to be risk factors associated with stroke recurrence include older age [1], large PFO [2,3,4,5] and large right-to-left shunting [6] and combined atrial septal aneurysm [7,8].
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