Patent Foramen Ovale: A Risk Factor for Stroke?

We searched for patent foramen ovale (PFO) ın patients referred to our echocardiography department for various indications. The study consisted of 1712 patients referred to transesophageal echocardiographic (TEE) examination between May 1995 and June 1998. Patients were evaluated in three groups according to their TEE indication. Five-hundred eighty-three patients who had valvular heart disease were excluded. Group I consisted of 42 patients (16 men, 26 women) under 40 years of age who were evaluated for a potential source of cardiac emboli. Group ll included 191 patients (95 men, 96 women) over 40 years of age who were likawise evaluated for a potential source of cardiac emboli. Group m consisted of 338 patients u nder 40 years of age ( 130 men, 208 women) sent for indications other than cardiac embolic source. Group IV consisted of remaining 558 patients over 40 years of age (274 men, 284 women) who were also, sent for indications other than evaluation of cardiac embolic source. PFO was evaluated by contrast study which was done with agitated saline injected into antecubital vein, and right-to-left shunting was evaluated in the fırst 3-5 cardiac cycles with and without Valsalva maneuver.
RESULTS
Overall PFO was seen in 99 of ı 129 patients (8.8%) watherees it occurred in 10 (23.8%), ıl (5.8%), 38 (I 1.2%), and 40 (7.2%) patients in Group I, ll, ın, and IV, respectively. Thaugh no statistically significant difference existed between Group II and Group IV, significant differences were found between Group I and Group ill (p<0.03). In conclusion, PFO is seen in approximately 8.8% of patients referred for young er patients with stroke are more bik:ely to reveal PFO than other groups. W e recommend that TEE and saline contrast study be done in young stroke patients.