European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism - Université Paris-Est-Créteil-Val-de-Marne Access content directly
Journal Articles European Heart Journal Year : 2019

European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism

Christian Pristipino
  • Function : Author
Horst Sievert
  • Function : Author
Fabrizio D’ascenzo
  • Function : Author
Jean Louis Mas
  • Function : Author
Bernhard Meier
  • Function : Author
Paolo Scacciatella
  • Function : Author
David Hildick-Smith
  • Function : Author
Fiorenzo Gaita
  • Function : Author
Danilo Toni
  • Function : Author
Paul Kyrle
  • Function : Author
John Thomson
  • Function : Author
Eustaquio Onorato
  • Function : Author
Dirk Sibbing
  • Function : Author
Peter Germonpré
  • Function : Author
Sergio Berti
  • Function : Author
Massimo Chessa
  • Function : Author
Francesco Bedogni
  • Function : Author
Dariusz Dudek
  • Function : Author
Marius Hornung
  • Function : Author
Jose Zamorano
  • Function : Author
Fabrizio D’ascenzo
  • Function : Author
Pierluigi Omedè
  • Function : Author
Flavia Ballocca
  • Function : Author
Umberto Barbero
  • Function : Author
Francesca Giordana
  • Function : Author
Sebastiano Gili
  • Function : Author
Mario Iannaccone
  • Function : Author
Davide Capodanno
  • Function : Author
Marco Valgimigli
  • Function : Author
Robert Byrne
  • Function : Author
Teiji Akagi
  • Function : Author
John Carroll
  • Function : Author
Bharat Dalvi
  • Function : Author
Junbo Ge
  • Function : Author
Scott Kasner
  • Function : Author
Ina Michel-Behnke
  • Function : Author
Carlos Pedra
  • Function : Author
John Rhodes
  • Function : Author
Lars Søndergaard
  • Function : Author
Lars Thomassen
  • Function : Author
Giuseppe Biondi-Zoccai
  • Function : Author

Abstract

Abstract The presence of a patent foramen ovale (PFO) is implicated in the pathogenesis of a number of medical conditions; however, the subject remains controversial and no official statements have been published. This interdisciplinary paper, prepared with involvement of eight European scientific societies, aims to review the available trial evidence and to define the principles needed to guide decision making in patients with PFO. In order to guarantee a strict process, position statements were developed with the use of a modified grading of recommendations assessment, development, and evaluation (GRADE) methodology. A critical qualitative and quantitative evaluation of diagnostic and therapeutic procedures was performed, including assessment of the risk/benefit ratio. The level of evidence and the strength of the position statements of particular management options were weighed and graded according to predefined scales. Despite being based often on limited and non-randomised data, while waiting for more conclusive evidence, it was possible to conclude on a number of position statements regarding a rational general approach to PFO management and to specific considerations regarding left circulation thromboembolism. For some therapeutic aspects, it was possible to express stricter position statements based on randomised trials. This position paper provides the first largely shared, interdisciplinary approach for a rational PFO management based on the best available evidence.

Dates and versions

hal-04395120 , version 1 (15-01-2024)

Identifiers

Cite

Christian Pristipino, Horst Sievert, Fabrizio D’ascenzo, Jean Louis Mas, Bernhard Meier, et al.. European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. European Heart Journal, 2019, 40 (38), pp.3182-3195. ⟨10.1093/eurheartj/ehy649⟩. ⟨hal-04395120⟩

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