Multinational survey on management of patients with patent foramen ovale and left circulation thromboembolism

Background: The purpose of our survey was to capture the contemporary clinical practice of interventional and imaging cardiologists specialising in PFO management in different parts of the world with special emphasis on practice patterns in three core areas: patient screening, procedure and follow-up.

Methods: An electronic questionnaire consisting of multiple-choice (single or multiple answers) or open-ended questions was sent in an email to suitable respondents identified by senior authors in their country/region of practice. All respondents were cardiology consultants directly involved in PFO closure procedures either as the operator, imaging specialist or in both roles. Responses were recorded between October 2019 and July 2020. There were no unanswered questions.

Results: Seventy-one responses were obtained from different parts of the world: 31 from the United Kingdom, 19 from the United States, 16 from Gulf Countries, two from Poland and one response each from Australia, Italy and Switzerland. The overall response rate was 76%. Regional differences between the US, the UK and Gulf Countries are presented in Table.

Conclusion: Based on the responses from the US, the UK and Gulf Countries, we show that there is no standard approach to patient selection, work-up and follow-up neither on international nor national/regional level. The results stress the need for systematic, high-quality data on diagnostic work-up and follow-up strategies to inform the standardised approach.