Valvular & structural heart disease
Association of incomplete device apposition with stroke recurrence after patent foramen ovale closure
Authors' conclusion
IDA is common after PFO closure and is associated with increased risks of recurrent stroke and new-onset symptoms. Preventive strategies warrant further investigation.
Study context
- Population
- Patients without known vascular risk factors who underwent transcatheter patent foramen ovale (PFO) closure for secondary prevention with follow-up ≥6 monthsincluded from 382 consecutive candidates
- Participants
- 233 patients
- Exposure
- Patients with incomplete device apposition (IDA) vs without IDA
Methodological detailsfour centres in China (2020-2026)
- Four centres in China (2020-2026)
Main finding
As reported in the abstract
Recurrent stroke · median follow-up of 20.00 (IQR 18.00-24.00) months
- IDA: P = 0.022
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| New-onset symptoms (atrial tachyarrhythmia, migraine headache, chest pain/discomfort) · median follow-up of 20.00 (IQR 18.00-24.00) months · higher risk with IDA | P < 0.001 |
Prevalence and location of IDA · 6 months post closure
- IDA observed
- 55.8%
- Predominantly at the anterior-inferior rim
- 93.4%
Factors associated with IDA
- IDA significantly associated with larger and longer PFOs, larger devices and greater in vivo device thickness
- P < 0.001 for all
Device apposition on repeat CT angiography (CTA)
- In eight patients who underwent repeat CTA, device apposition remained stable after 6-month closure
Pathological validation
- Available in one patient with severe chest pain/discomfort; a well-apposed device had sufficient endothelialisation
Original publication
Association of incomplete device apposition with stroke recurrence after patent foramen ovale closure. Heart. Published 7 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it