Transcatheter closure of patent foramen ovale in older adults

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Abstract
Objectives:: Comparing results of patent foramen ovale (PFO) closure in older and younger patient cohorts.Background:: The literature pertaining to stroke and PFO has focused on patients 55years of age at the time of the procedure (mean 66.9 ± 8.3 years) and comprise the subject group (OLDER). The remaining 272 patients (mean 41.1 ± 7.7) comprise thecontrol group (YOUNGER). Data were collected prospectively in a registry type format.Results:: Minor procedural complications were comparable: 7/184 (3.8%) OLDER vs. 12/272 (4.4%) YOUNGER (P = NS). In the follow‐up period (1–45 months, mean = 17.8 ± 11.1), there was no significant difference in the rate of recurrent stroke/TIA, headaches, or late unrelated death. Forty OLDER patients and 47 YOUNGER developed new onset atrial arrhythmia (P = NS). The incidence of new onset atrial fibrillation (AF), however, was significantly higher in OLDER (14/40 OLDER and only 2/47 YOUNGER, P < 0.025). All patients who were in normal sinus rhythm (NSR) before the procedure are in NSR at last follow‐up.Conclusions:: Older patients should not be excluded from PFO closure. The procedure seems as safe and effective in preventing recurrent stroke in the older, as in the younger population. Older patients seem more prone to developing AF.