Fechamento cirúrgico do forame oval patente na prevenção de acidente vascular cerebral isquêmico recorrente em casos de acidente vascular cerebral isquêmico criptogênico: uma revisão sistemática

Maria Fernanda de Oliveira Moraes; Rafael Carraro de Rezende; Caio Sachetto Toledo Bellini; Maria Inês Boechat Gomes

doi:10.58951/dataset.2024.024

Surgical closure of the patent foramen ovale in the prevention of recurrent ischemic stroke in cases of cryptogenic ischemic stroke: a systematic review

Authors

Maria Fernanda de Oliveira Moraes Faculdade de Ciências Médicas e da Saúde de Juiz de Fora – SUPREMA https://orcid.org/0009-0007-4133-900X
Rafael Carraro de Rezende Faculdade de Ciências Médicas e da Saúde de Juiz de Fora – SUPREMA https://orcid.org/0009-0000-8761-0132
Caio Sachetto Toledo Bellini Faculdade de Ciências Médicas e da Saúde de Juiz de Fora – SUPREMA https://orcid.org/0009-0006-1936-9061
Maria Inês Boechat Gomes Faculdade de Ciências Médicas e da Saúde de Juiz de Fora – SUPREMA https://orcid.org/0009-0009-9063-1394

DOI:

https://doi.org/10.58951/dataset.2024.024

Keywords:

Patent foramen ovale, Surgery, Cryptogenic stroke, Ischemic stroke, Antithrombotics

Abstract

Patent foramen ovale (PFO) is characterized by non-closure of the orifice that connects the atria during fetal life. This type of cardiac anomaly can contribute to the circulation of thrombi in the blood system, which can consequently cause a cryptogenic ischemic stroke. For these patients, both antithrombotic therapy (ATT) and surgical closure of the PFO are indicated. The objective of this study is to evaluate the effectiveness of surgical closure of the PFO, compared to ATT, in preventing recurrent stroke in patients with PFO who have suffered cryptogenic stroke. For this, cohort studies, systematic reviews and clinical trials published in the last 10 years in the MedLine database were analyzed, using descriptors “Patent foramen ovale”, “Cryptogenic stroke” and “Antiplatelets”. After applying the inclusion and exclusion criteria, four studies were included in the analysis. The results from the selected studies indicate that there are divergences regarding the effectiveness of surgical closure of the PFO in reducing the risk of recurrent stroke, compared to ATT, for the patients considered. However, this reduction appears more significant (p<0.05) when considering subgroups of patients with wide shunt and interatrial septal aneurysm. These factors, according to previous literature, are associated with the recurrence of cryptogenic stroke, which may have contributed to the greater effectiveness of surgical closure of the PFO in these patients. It is concluded that the surgical closure of the PFO was more effective in preventing recurrent stroke, compared to ATT, in patients with a wide shunt or interatrial septal aneurysm, therefore, it tends to be more suitable for these patients.

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