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Repair of Patent Foramen Ovale May Not Be Beneficial

Surgical closure is associated with an increased risk of postoperative stroke and no clear benefits

TUESDAY, July 14 (HealthDay News) -- Patients with a patent foramen ovale that is discovered and repaired during unrelated surgery may have a significantly increased risk of postoperative stroke, according to a study published in the July 15 issue of the Journal of the American Medical Association.

Richard A. Krasuski, M.D., of the Cleveland Clinic, and colleagues reviewed the intraoperative transesophageal echocardiograms of 13,092 surgical patients, including 2,277 with an intraoperatively discovered patent foramen ovale. Of these, 639 underwent surgical repair.

The researchers found that the rate of in-hospital stroke was significantly higher in patients who underwent surgical repair than in those who did not (2.8 versus 1.2 percent). They also found that there was no difference between those with patent foramen ovale and those without in the rate of hospital deaths, ICU length of stay and time on cardiopulmonary bypass, and that repair was not associated with improved long-term survival.

"The finding that repair may increase postoperative stroke risk should discourage routine surgical closure and foster further investigation to delineate whether there is any benefit in terms of long-term stroke prevention and which patients might benefit from this intervention," the authors conclude.

One author reported an association with two medical companies.

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