Journal article
Patent Foramen Ovale Closure in Right Ventricular Failure on Mechanical Circulatory Support: To Close or Not?
JACC. Case reports, v 30(31), 105301
08 Oct 2025
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Abstract
Background: Right-to-left shunting through a patent foramen ovale (PFO) can cause severe hypoxemia in right ventricular (RV) failure; however, closure may worsen RV function and risk hemodynamic collapse. Case Summary: A 40-year-old man with arrhythmogenic RV dysplasia and profound RV failure developed refractory hypoxemia due to a large PFO while supported on venoarterial extracorporeal membrane oxygenation and intra-aortic balloon pump. After multidisciplinary assessment, he underwent successful percutaneous PFO closure, leading to improved oxygenation, RV stability, and decannulation from mechanical circulatory support. Discussion: This rare case involving dual mechanical support illustrates the complexity of managing PFOs in RV failure. It challenges conventional caution against closure and emphasizes the importance of individualized, team-based decision-making guided by careful physiological assessment. Take-Home Messages: PFO closure may be feasible in RV failure with mechanical circulatory support. Multidisciplinary planning is essential to optimize outcomes.
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Details
- Title
- Patent Foramen Ovale Closure in Right Ventricular Failure on Mechanical Circulatory Support: To Close or Not?
- Creators
- Erasmus Mutabi - Allegheny General HospitalCharles Ebersbacher - Allegheny General HospitalColin Pesyna - Allegheny General HospitalCandice Lee - Allegheny General HospitalCraig Alpert - Allegheny General HospitalRyan Watson - Allegheny General HospitalKarthikeyan Ranganathan - Allegheny General Hospital
- Publication Details
- JACC. Case reports, v 30(31), 105301
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Scopus ID
- 2-s2.0-105017022171
- Other Identifier
- 991022121037904721