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Although a PFO may be discovered incidentally and remain asymptomatic throughout life, it can also be a conduit for paradoxical emboli or vasoactive substances and has been associated with neurological disorders, including cryptogenic stroke, transient ischemic attack, migraine, epilepsy, as well as systemic embolism, hypoxemic disorders, and decompression sickness, particularly in individuals with high\u2010risk anatomy or traditional cardiovascular risk factors. However, accurate identification of pathogenic PFO remains a challenge in current clinical practice, and the indications, timing, and long\u2010term safety of PFO closure remain controversial. In this review, we summarize the epidemiology, risk factors, pathophysiological mechanisms, clinical manifestations, diagnostic strategies, and management of PFO, with particular emphasis on risk stratification, emerging imaging tools, novel closure devices, procedure\u2010related complications, and the application of closure in special populations. In addition, we focused on the current evidence regarding when and who may benefit from PFO intervention and the surveillance of postprocedural complications. Overall, this review provides a comprehensive overview of the current findings and future perspectives for the management of PFO.<\/jats:p>","DOI":"10.1002\/mco2.70957","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T02:17:19Z","timestamp":1788747439000},"source":"Crossref","is-referenced-by-count":0,"title":["Patent Foramen Ovale: Epidemiology, Risk Factors, Pathophysiology, Clinical Features, Diagnosis, and Management"],"prefix":"10.1002","volume":"7","author":[{"given":"Linlin","family":"Meng","sequence":"first","affiliation":[{"name":"State Key Laboratory for Innovation and Transformation of Luobing Theory; Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province; Department of Cardiology, Qilu Hospital of Shandong University; Cheeloo College of Medicine Shandong University  Jinan Shandong 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