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Percutaneous closure of the patent foramen ovale for the prevention of cerebral embolic stroke

 
Guidance issued
 
Number: IPG109

Summary

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous closure of the patent foramen ovale for the prevention of cerebral embolic stroke.

Description

A patent foramen ovale is the persistence of a hole (the foramen ovale) in the wall (septum) between the right atrium and left atrium of the heart. The foramen ovale usually closes spontaneously after birth; however, in as many as 1 out of 4 people, the foramen ovale does not close completely and it remains patent throughout life. In most people, the persistence of a patent foramen ovale does not cause any complications. Treatment is usually aimed at patients with a history of previous cerebral embolic events.

Treatment options include medical treatment with antiplatelet (eg aspirin) or anticoagulation therapy, surgical closure (open-heart surgery), and percutaneous closure of the patent foramen ovale.

Percutaneous closure involves making a small incision in the groin under intravenous sedation. A guidewire and delivery sheath are then introduced into the vein and passed into the heart, across the patent foramen ovale. A closure device is inserted through the opening via the delivery sheath and released, closing the foramen ovale.

OPCS code:

Details

Arrangement:
Special
Topic area:
Cardiovascular
Central nervous system
Surgical procedures
Specialty:
Cardio-thoracic surgery
Specialist advice has been sought from:
Date notified to NICE:
21 October 2003
Provisional consultation date:
September 2004
Guidance issue date:
26 January 2005

Contact details:

Project manager (for general enquiries or comments)
(for general enquiries or comments)
Technical lead
(for procedure specific enquiries or comments)
Sally Wortley
ip@nice.org.uk
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA

Links: