Document Detail


Patent foramen ovale closure in recreational divers: effect on decompression illness and ischaemic brain lesions during long-term follow-up.
MedLine Citation:
PMID:  21917666     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ObjectiveTo test the effect of patent foramen ovale (PFO) closure on neurological events in divers.DesignProspective, non-randomised, longitudinal three-arm study.SettingTertiary referral centre.Population104 scuba divers with a history of major decompression illness (DCI).InterventionTranscutaneous PFO closure.Main outcome measuresBaseline and three follow-up examinations with a questionnaire about health status and diving habits/accidents, transoesophageal echocardiography at baseline for PFO grading, cerebral MRI at all examinations.Results39 divers had no PFO, 26 had a PFO and chose to undergo percutaneous closure and 39 had a PFO, but decided not to undergo closure. The total number of dives, including those performed before baseline and those during long-term follow-up, was 81 654; 18 394 dives during the follow-up period of 5.3±0.3 years, during which there were a total of five major neurological DCI events-namely 0 in the no PFO group, 0.5±2.5/10(4) dives in the PFO closure group and 35.8±102.5/10(4) dives in the PFO no closure group (four events; p=0.045 between the PFO groups). In the groups, no PFO, PFO closure and PFO no closure, there were 1.1±2.6, 0.8±1.4, 3.3±6.9 ischaemic brain lesions, respectively, at follow-up (p=0.039 between the PFO groups)-that is, 16±42/10(4) dives in the no PFO group, 6±13/10(4) dives in the PFO closure group and 104±246/10(4) dives in the PFO no closure group (overall p=0.042; p=0.024 between the PFO groups).ConclusionPFO closure in continuing divers appears to prevent symptomatic (major DCI) and asymptomatic (ischaemic brain lesions) neurological events during long-term follow-up.
Authors:
Michael Billinger; Rainer Zbinden; Raffaela Mordasini; Stephan Windecker; Markus Schwerzmann; Bernhard Meier; Christian Seiler
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-13
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  -     ISSN:  1468-201X     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University Hospital, Bern, Switzerland.
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