Abstract
Objectives: One of the less controversial indications for percutaneous closure (C) of a patent foramen ovale (PFO) may be reduction of recurrent cerebral thromboembolic events, although these may sometimes recur after PFO-C. Hypercoagulable states are among the less well understood causes of cryptogenic stroke (CS). The reported prevalence of coagulopathies in patients with PFO varies widely and there is no consensus concerning their role. Methods and results: This single centre observational study examined the prevalence of coagulopathies in 49 consecutive patients below 65 years of age in whom PFO-C was performed. Heterozygous mutation of factor V (Leiden) gene was detected in 6 patients (12%), prothrombin gene mutation in 3 patients (6%), protein S deficiency in 1 (2%), antiphospholipid antibodies in 1 (2%), and antithrombin III deficiency in 1 (2%). In all, a coagulopathy was detected in 11 patients (22.5%). During the follow-up period of 13 ± 5.5 months no cerebrovascular or other thromboembolic event occurred. Conclusion: Heterozygous forms of inherited coagulopathies may be more frequent in patients with PFO and CS than in the general population, thus potentially contributing to the original event of paradoxical embolisation. Data from larger centres and metaanalysis of existing data may help to clarify the role of coagulopathies further.