[Percutaneous closure of patent foramen ovale, as secondary prevention of cryptogenic cerebral event]. / Nyitott foramen ovale katéteres záráisa, a cryptogen agyi történés szekunder prevenciója.

In patients with patent foramen ovale and cryptogenic stroke, the risk of recurrent event is about 4-5% yearly, despite of the antithrombotic treatment. Transcatheter closure of patent foramen ovale has been shown to decrease risk of recurrence. This report summarizes the first experiences in Hungary and the medium term follow up of our patients. Thirty-three patients were selected for closure. All the patients had at least one ischemic stroke, transitory ischemic attack or peripheral embolus. In 31 of them the stroke was confirmed by computer tomographic or magnetic resonance imaging. Patent foramen ovale with right-to-left shunt was diagnosed by transesophageal echocardiography. Transcatheter closure was performed under fluoroscopic and transesophageal echocardiographic control. Closure was successful in 31 patients. Passage of atrial septum did not succeed in two cases. An AV fistula at puncture site was the only early complication. There was no late complication. No device dislocation, periprocedural arrhythmia or embolic event was detected. No residual shunt could be found. During follow up of 11.3 (1-30) months no recurrent embolus was detected. Transcatheter closure of patent foramen ovale is a safe and efficient procedure to decrease the risk of recurrent ischemic events.

[Pharmacologic prevention of cardiovascular diseases--2005]. / A cardiovascularis prevenció gyógyszeres lehetoségei--2005.

Cardiovascular diseases are the leading cause of death in Western countries, and that is true for Hungary as well, and so will be the case in developing countries in 2025. Cardiovascular diseases kill more than 950000 people only in the USA. 50% of cardiovascular mortality is due to ischemic heart disease, stroke is responsible for 20%. The annual cost of the treatment of cardiovascular illnesses takes more than 330 billion dollars. All these data underline the importance of these illnesses. The aim of cardiovascular prevention is to reduce the incidence of first or recurrent events due to ischemic heart disease, ischemic stroke or peripheral artery disease, especially early deaths and disability. In the following article the medical aspects of cardiovascular prevention are summarized. Lifestyle changes and special treatment of particular risk factors are out of scope of this review.