6.2 PFO Closure: What Goes Around Comes Around?

These proceedings summarize the educational activity of the 16th Biennial Meeting of the International Andreas Gruentzig Society held January 31-February 3, 2022 in Punta Cana, Dominican Republic

Faculty Disclosures     Vendor Acknowledgments

2022 IAGS Summary Document

 Statement of the problem or issue

Nonsurgical percutaneous closure of PFOs and ASDs dates from the invention of the King-Mills device used first experimentally in dogs in 1972, then with the first human implant performed in 1975. This was a clamshell-umbrella device that was bulky and very challenging. Since that time there have been other devices developed, and device manufacturers continue to work on these although it is not a high priority area. Some of the problems associated with these devices and the implantation procedure are listed in Table 1.

Gaps in Knowledge

In addition to finding solutions to the problems listed in Table 1, the major gaps in our knowledge base are: (1) finding the “right” size and shape for a permanent closure device; (2) preventing tissue erosion; (3) understanding the links between patent foramen ovale, atrial fibrillation, and stroke.

Possible solutions and future directions

There will be both small, incremental improvements as well as large paradigm shifts that occur. A list of important future possibilities is shown in Table 2A and Table 2B.