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:  MEDLINE    
OBJECTIVE: To test the effect of patent foramen ovale (PFO) closure on neurological events in divers.
DESIGN: Prospective, non-randomised, longitudinal three-arm study.
SETTING: Tertiary referral centre.
POPULATION: 104 scuba divers with a history of major decompression illness (DCI).
INTERVENTION: Transcutaneous PFO closure.
MAIN OUTCOME MEASURES: Baseline 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.
RESULTS: 39 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 ± 2.5/10⁴ dives in the PFO closure group and 35.8 ± 102.5/10⁴ 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 ± 42/10⁴ dives in the no PFO group, 6 ± 13/10⁴ dives in the PFO closure group and 104 ± 246/10⁴ dives in the PFO no closure group (overall p = 0.042; p = 0.024 between the PFO groups).
CONCLUSION: PFO closure in continuing divers appears to prevent symptomatic (major DCI) and asymptomatic (ischaemic brain lesions) neurological events during long-term follow-up.
Michael Billinger; Rainer Zbinden; Raffaela Mordasini; Stephan Windecker; Markus Schwerzmann; Bernhard Meier; Christian Seiler
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Publication Detail:
Type:  Journal Article     Date:  2011-09-13
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  97     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-07     Completed Date:  2011-12-20     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1932-7     Citation Subset:  AIM; IM    
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MeSH Terms
Brain Ischemia / diagnosis,  prevention & control*
Cardiac Catheterization*
Decompression Sickness / prevention & control*
Diving / adverse effects*,  statistics & numerical data
Echocardiography, Transesophageal / methods
Follow-Up Studies
Foramen Ovale, Patent / surgery*,  ultrasonography
Health Status
Magnetic Resonance Imaging / methods
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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