Valvular & structural heart disease
Prevalence, classification, and treatment of residual shunt after patent foramen ovale closure
Authors' conclusion
RS is commonly found after transcatheter PFO closure and is significantly associated with the type and size of the occluding device implanted. It results from different mechanisms and can be safely and effectively treated by a percutaneous, patient-tailored approach in a high percentage of cases.
Study context
- Population
- Patients with residual shunt at transcranial Doppler after transcatheter PFO closure, 2000–2022patients who underwent PFO closure
- Participants
- 2,362 patients
- Comparison
- Residual shunt rates by occluding device type and size
- Outcome
- Any grade and significant RS
Main finding
As reported in the abstract
Any grade RS
8.8%
Significant RS
3.6%
Further findings
RS by occluding device
- RS by occluding device: p<0.00001
- RS among double-disc device implantations, by device stiffness: stiffer devices 9.8%
- RS among double-disc device implantations, by device stiffness: other double-disc devices 7.1%
- RS among double-disc device implantations, by device stiffness: p<0.05
- RS among double-disc device implantations, by device size: devices larger than 25 mm 13.9%
- RS among double-disc device implantations, by device size: other double-disc devices 6.6%
- RS among double-disc device implantations, by device size: p<0.00001
RS type
- Intradiscal RS (type 1)
- 43.6%
- Extradiscal RS (type 2)
- 35.1%
- RS due to unusual causes (type 3)
- 14.9%
Success of percutaneous treatment
- Successful percutaneous treatment, using different, anatomically tailored devices
- 89.4%
Original publication
Prevalence, classification, and treatment of residual shunt after patent foramen ovale closure. EuroIntervention. Published 18 August 2025. doi:10.
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