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Patent foramen ovale in children: Unique pediatric challenges and lessons learned from adult literature


1 Department of Pediatrics, Division of Cardiology, Hassenfeld Children's Hospital, New York University Langone Health, New York, NY, USA
2 Department of Pediatrics, Division of Cardiology, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
3 Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children's Hospital and University of Washington, Seattle, WA, USA
4 Department of Pediatrics, Division of Critical Care, Primary Children's Hospital and University of Utah, Salt Lake City, UT, USA
5 Department of Pediatrics, Division of Pediatric Cardiology, Baylor College of Medicine, Houston, TX, USA
6 Director, Cardiology Care for Children, Lancaster, PA, USA
7 Department of Pediatrics, Division of Pediatric Cardiology, University of Chicago, Chicago, IL, USA
8 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
9 Department of Surgery, Section of Congenital and Pediatric Cardiac Surgery, New York University Langone Health, New York, NY, USA
10 Department of Surgery, Section of Congenital and Pediatric Cardiac Surgery, Oregon Health and Science University, Portland, OR, USA
11 Department of Pediatrics, Heart and Vascular Institute, Arnot Health, Elmira, New York, USA
12 Department of Pediatrics, Division of Cardiology, University of Miami Miller School of Medicine, Miami, FL, USA
13 Department of Pediatrics, Division of Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York, NY, USA
14 Department of Pediatrics, Division of Cardiology, University of Texas Health Science Center at Houston, Houston, TX, USA
15 Department of Pediatrics, Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
16 Department of Pediatrics, Division of Cardiology, Oregon Health and Science University, Portland, OR, USA

Correspondence Address:
Dr. Sunil Saharan
Department of Pediatrics, Division of Cardiology, New York University Langone Health, 550 First Avenue, New York, NY 10016
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_67_21

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Year : 2022  |  Volume : 15  |  Issue : 1  |  Page : 44-52

 

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A patent foramen ovale (PFO) is a frequent incidental finding during echocardiography in otherwise healthy children. In most healthy children with a diagnosis of isolated incidental PFO, no further follow-up or intervention is necessary. In some children, PFO is associated with certain clinical syndromes such as cryptogenic stroke, decompression sickness, migraine, and platypnea–orthodeoxia syndrome. This review discusses PFO anatomy, diagnostic imaging, PFO-associated clinical situations, management options, and the role of PFO in certain congenital heart disease. This review also highlights the current deficiency of pediatric data guiding management of these uncommon but important PFO-associated conditions. Future multicenter randomized controlled studies are necessary to guide the management of these unique and challenging PFO-associated conditions.






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1 Department of Pediatrics, Division of Cardiology, Hassenfeld Children's Hospital, New York University Langone Health, New York, NY, USA
2 Department of Pediatrics, Division of Cardiology, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
3 Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children's Hospital and University of Washington, Seattle, WA, USA
4 Department of Pediatrics, Division of Critical Care, Primary Children's Hospital and University of Utah, Salt Lake City, UT, USA
5 Department of Pediatrics, Division of Pediatric Cardiology, Baylor College of Medicine, Houston, TX, USA
6 Director, Cardiology Care for Children, Lancaster, PA, USA
7 Department of Pediatrics, Division of Pediatric Cardiology, University of Chicago, Chicago, IL, USA
8 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
9 Department of Surgery, Section of Congenital and Pediatric Cardiac Surgery, New York University Langone Health, New York, NY, USA
10 Department of Surgery, Section of Congenital and Pediatric Cardiac Surgery, Oregon Health and Science University, Portland, OR, USA
11 Department of Pediatrics, Heart and Vascular Institute, Arnot Health, Elmira, New York, USA
12 Department of Pediatrics, Division of Cardiology, University of Miami Miller School of Medicine, Miami, FL, USA
13 Department of Pediatrics, Division of Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York, NY, USA
14 Department of Pediatrics, Division of Cardiology, University of Texas Health Science Center at Houston, Houston, TX, USA
15 Department of Pediatrics, Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
16 Department of Pediatrics, Division of Cardiology, Oregon Health and Science University, Portland, OR, USA

Correspondence Address:
Dr. Sunil Saharan
Department of Pediatrics, Division of Cardiology, New York University Langone Health, 550 First Avenue, New York, NY 10016
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_67_21

Rights and Permissions

A patent foramen ovale (PFO) is a frequent incidental finding during echocardiography in otherwise healthy children. In most healthy children with a diagnosis of isolated incidental PFO, no further follow-up or intervention is necessary. In some children, PFO is associated with certain clinical syndromes such as cryptogenic stroke, decompression sickness, migraine, and platypnea–orthodeoxia syndrome. This review discusses PFO anatomy, diagnostic imaging, PFO-associated clinical situations, management options, and the role of PFO in certain congenital heart disease. This review also highlights the current deficiency of pediatric data guiding management of these uncommon but important PFO-associated conditions. Future multicenter randomized controlled studies are necessary to guide the management of these unique and challenging PFO-associated conditions.






[FULL TEXT] [PDF]*


        
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