Interventional closure of an open foramen ovale in a patient with recurrent cerebral ischemia

: In a 24-year-old female patient suffering from recurrent ischemia, an aneurysm of the atrial septum and a patent foramen ovale with significant right-to-left shunt during the Valsalva maneuver were detected by means of contrast Doppler echocardiography. After other causes had been excluded, paradoxical embolism was suspected to be the cause of the cerebral symptoms. The defect was closed by a 17-mm Rashkind occluder without complications. Six months later no residual shunt was detected and no further neurological event had occurred. This case demonstrates the feasibility of non-operative closure of those defects. This new technique could represent an alternative to long-term anticoagulation or operative procedures in selected patients.