Long term follow-up of patent foramen closure due to embolic infarction in elderly patients

Abstract

Abstract Background In patients < 60 years (yrs) with crytogenic embolism associated with a patent foramen ovale (PFO) guidelines recommend interventional closure based on several randomized studies. There is no recommendation for elderly patients, although they seem to carry a similar risk for recurrent events. There are only scarce data on early and particularly late outcome. Methods We therefore retrospectively analyzed the up to 10 years outcome (median 4,2 yrs) in 444 consecutive patients (female, male) according to age at PFO closure. Results From 444 patients in our study population, 155 were >60 years of age (mean age 66,7 (IQR 63,1-71,74), 45% females. Older patients had higher prevalence of cardiovascular risk factors like hypertension, hyperlipidemia and diabetes (p< 0,01 for all vs. younger patients) while smoking was more prevalent in younger patients (p<0,01). No difference in procedural success and periinterventional complications was observed between the two age groups. During follow up of median 4,2 years (5 patients lost to FU) event rate of recurrent stroke, atrial fibrillation and acute myocardial infarction did not differ between older and younger patients. Conclusions Long term outcome was independent of age despite higher CV risk factors burden and supports PFO closure in elderly patients.