{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:38:04Z","timestamp":1788781084276,"version":"build-2803163510"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The support has been provided by clinical trials and guidelines for managing patent foramen ovale (PFO) in adults; however, the optimal approach is still unclear for treating PFO in pediatric patients. PFO and its associated clinical syndromes, imaging diagnosis, and management in pediatric patients were analyzed by a comprehensive analysis. Extensive research was performed using electronic databases, including PubMed, Cochrane, Web of Science, and EMBASE. This review includes the studies published until February 1st, 2024. A total of 583 articles were obtained, of which 54 were included in the comprehensive review. Numerous evidences have indicated that a right-to-left shunt through a PFO may be involved in cryptogenic stroke in children, although the connection between migraine and aura has not been substantiated by robust evidence. Children with sickle cell disease and a PFO were at higher risks of paradoxical embolization, rare syndromes caused by PFO could also occur in children such as platypnea\u2013orthodeoxia syndrome, myocardial infarction, and decompression sickness. Contrast transthoracic echocardiography was deemed the most appropriate examination for children due to its favorable transthoracic windows, eliminating the need for anesthesia. This review suggested that the additional treatment was not needed as no evidence was provided for potential future complications linked to isolated PFO in children. For children facing unique circumstances related to PFO, a customized interdisciplinary consultation is essential prior to considering medical interventions.<\/jats:p>","DOI":"10.1007\/s00246-024-03526-5","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T09:02:08Z","timestamp":1717232528000},"page":"1131-1141","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Patent Foramen Ovale in Children: A Review of Recent Progress"],"prefix":"10.1007","volume":"46","author":[{"given":"Tingting","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,1]]},"reference":[{"key":"3526_CR1","doi-asserted-by":"publisher","first-page":"15086","DOI":"10.1038\/nrdp.2015.86","volume":"2","author":"S Homma","year":"2016","unstructured":"Homma S, Mess\u00e9 SR, Rundek T, Sun YP, Franke J, Davidson K, Sievert H, Sacco RL, Di Tullio MR (2016) Patent foramen ovale. Nat Rev Dis Primer 2:15086","journal-title":"Nat Rev Dis Primer"},{"key":"3526_CR2","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1056\/NEJMoa1707404","volume":"377","author":"L S\u00f8ndergaard","year":"2017","unstructured":"S\u00f8ndergaard L, Kasner SE, Rhodes JF, Andersen G, Iversen HK, Nielsen-Kudsk JE, Settergren M, Sj\u00f6strand C, Roine RO, Hildick-Smith D, Spence JD, Thomassen L (2017) Patent foramen ovale closure or antiplatelet therapy for cryptogenic stroke. N Engl J Med 377:1033\u20131042","journal-title":"N Engl J Med"},{"key":"3526_CR3","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1056\/NEJMoa1705915","volume":"377","author":"JL Mas","year":"2017","unstructured":"Mas JL, Derumeaux G, Guillon B, Massardier E, Hosseini H, Mechtouff L, Arquizan C, B\u00e9jot Y, Vuillier F, Detante O, Guidoux C, Canaple S, Vaduva C, Dequatre-Ponchelle N, Sibon I, Garnier P, Ferrier A, Timsit S, Robinet-Borgomano E, Sablot D, Lacour JC, Zuber M, Favrole P, Pinel JF, Apoil M, Reiner P, Lefebvre C, Gu\u00e9rin P, Piot C, Rossi R, Dubois-Rand\u00e9 JL, Eicher JC, Meneveau N, Lusson JR, Bertrand B, Schleich JM, Godart F, Thambo JB, Leborgne L, Michel P, Pierard L, Turc G, Barthelet M, Charles-Nelson A, Weimar C, Moulin T, Juliard JM, Chatellier G (2017) Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke. N Engl J Med 377:1011\u20131021","journal-title":"N Engl J Med"},{"key":"3526_CR4","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1056\/NEJMoa1610057","volume":"377","author":"JL Saver","year":"2017","unstructured":"Saver JL, Carroll JD, Thaler DE, Smalling RW, MacDonald LA, Marks DS, Tirschwell DL (2017) Long-term outcomes of patent foramen ovale closure or medical therapy after stroke. N Engl J Med 377:1022\u20131032","journal-title":"N Engl J Med"},{"key":"3526_CR5","doi-asserted-by":"publisher","first-page":"2029","DOI":"10.1093\/eurheartj\/ehw027","volume":"37","author":"HP Mattle","year":"2016","unstructured":"Mattle HP, Evers S, Hildick-Smith D, Becker WJ, Baumgartner H, Chataway J, Gawel M, G\u00f6bel H, Heinze A, Horlick E, Malik I, Ray S, Zermansky A, Findling O, Windecker S, Meier B (2016) Percutaneous closure of patent foramen ovale in migraine with aura, a randomized controlled trial. Eur Heart J 37:2029\u20132036","journal-title":"Eur Heart J"},{"key":"3526_CR6","doi-asserted-by":"publisher","first-page":"2766","DOI":"10.1016\/j.jacc.2017.09.1105","volume":"70","author":"JM Tobis","year":"2017","unstructured":"Tobis JM, Charles A, Silberstein SD, Sorensen S, Maini B, Horwitz PA, Gurley JC (2017) Percutaneous closure of patent foramen ovale in patients with migraine: the premium trial. J Am Coll Cardiol 70:2766\u20132774","journal-title":"J Am Coll Cardiol"},{"key":"3526_CR7","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/1129-2377-14-79","volume":"14","author":"B Bellini","year":"2013","unstructured":"Bellini B, Arruda M, Cescut A, Saulle C, Persico A, Carotenuto M, Gatta M, Nacinovich R, Piazza FP, Termine C, Tozzi E, Lucchese F, Guidetti V (2013) Headache and comorbidity in children and adolescents. J Headache Pain 14:79","journal-title":"J Headache Pain"},{"key":"3526_CR8","doi-asserted-by":"publisher","first-page":"e2096","DOI":"10.1212\/WNL.0000000000012892","volume":"97","author":"EK Shih","year":"2021","unstructured":"Shih EK, Beslow LA, Natarajan SS, Falkensammer CB, Mess\u00e9 SR, Ichord RN (2021) Prevalence of patent foramen ovale in a cohort of children with cryptogenic ischemic stroke. Neurology 97:e2096\u2013e2102","journal-title":"Neurology"},{"key":"3526_CR9","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1002\/ccd.21305","volume":"70","author":"MP Benedik","year":"2007","unstructured":"Benedik MP, Zaletel M, Meglic NP, Podnar T (2007) Patent foramen ovale and unexplained ischemic cerebrovascular events in children. Catheter Cardiovasc Interv 70:999\u20131007","journal-title":"Catheter Cardiovasc Interv"},{"key":"3526_CR10","doi-asserted-by":"publisher","first-page":"385","DOI":"10.5603\/KP.a2015.0194","volume":"74","author":"M Wawrzy\u0144czyk","year":"2016","unstructured":"Wawrzy\u0144czyk M, Ga\u0142eczka M, Karwot B, Knop M, Bia\u0142kowski J (2016) Efficiency of transcatheter patent foramen ovale closure in children after paradoxical embolism events. Kardiol Pol 74:385\u2013389","journal-title":"Kardiol Pol"},{"key":"3526_CR11","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.acvd.2020.03.021","volume":"113","author":"N Miton","year":"2020","unstructured":"Miton N, Godart F, Milani G, Jalal Z, Karsenty C, Baruteau AE, Gronier C, Aldebert P, Douchin S, Lucron H, Chalard A, Houeijeh A, Petit J, Hascoet S, Thambo JB, Dauphin C (2020) Patent foramen ovale closure in children without cardiopathy: child-PFO study. Arch Cardiovasc Dis 113:513\u2013524","journal-title":"Arch Cardiovasc Dis"},{"key":"3526_CR12","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.pediatrneurol.2013.11.007","volume":"50","author":"SC Menon","year":"2014","unstructured":"Menon SC, Grove A, McFadden M, Korgenski KE, Cowley CG (2014) Clinical practice, resource utilization, and outcomes of device closure of patent foramen ovale in pediatrics. Pediatr Neurol 50:213\u2013217","journal-title":"Pediatr Neurol"},{"key":"3526_CR13","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1017\/S1047951117000725","volume":"27","author":"K Sel","year":"2017","unstructured":"Sel K, Aykan HH, Duman D, Aypar E, \u00d6zkutlu S, Alehan D, Karag\u00f6z T (2017) Transcatheter closure of the patent foramen ovale in children: intermediate-term follow-up results. Cardiol Young 27:1545\u20131549","journal-title":"Cardiol Young"},{"key":"3526_CR14","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s00431-012-1875-5","volume":"172","author":"M Perkovi\u010d-Benedik","year":"2013","unstructured":"Perkovi\u010d-Benedik M, Zaletel M, Pe\u010dari\u010d-Megli\u010d N, Podnar T (2013) A right-to-left shunt and prothrombotic disorders in pediatric patients presenting with transient ischemic attack. Eur J Pediatr 172:239\u2013245","journal-title":"Eur J Pediatr"},{"key":"3526_CR15","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1136\/adc.2010.203992","volume":"96","author":"MP Benedik","year":"2011","unstructured":"Benedik MP, Zaletel M, Meglic NP, Podnar T (2011) A right-to-left shunt in children with arterial ischaemic stroke. Arch Dis Child 96:461\u2013467","journal-title":"Arch Dis Child"},{"key":"3526_CR16","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1177\/0333102413477740","volume":"33","author":"DY Choi","year":"2013","unstructured":"Choi DY, Shin DH, Cho KH, Lee SP, Park S (2013) Migraine with aura: a predictor of patent foramen ovale in children and adolescents. Cephalalgia 33:463\u2013468","journal-title":"Cephalalgia"},{"key":"3526_CR17","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.jpeds.2011.01.062","volume":"159","author":"RT McCandless","year":"2011","unstructured":"McCandless RT, Arrington CB, Nielsen DC, Bale JF Jr, Minich LL (2011) Patent foramen ovale in children with migraine headaches. J Pediatr 159:243-247.e241","journal-title":"J Pediatr"},{"key":"3526_CR18","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s13052-023-01572-y","volume":"50","author":"R Zou","year":"2024","unstructured":"Zou R, Wang S, Liu P, Chen D, Yan J, Cai H, Wang Y, Wang C (2024) The association between patent foramen ovale and unexplained syncope in pediatric patients. Ital J Pediatr 50:2","journal-title":"Ital J Pediatr"},{"key":"3526_CR19","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1007\/s12098-020-03243-w","volume":"87","author":"EH Lee","year":"2020","unstructured":"Lee EH, Han MY (2020) Transcatheter patent foramen ovale closure in a child with cryptogenic ischemic stroke. Ind J Pediatr 87:653","journal-title":"Ind J Pediatr"},{"key":"3526_CR20","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1002\/ccd.25183","volume":"84","author":"J Hill","year":"2014","unstructured":"Hill J, Preminger T (2014) Percutaneous PFO closure for paradoxical stroke in 8-kg twins. Catheter Cardiovasc Interv 84:110\u2013113","journal-title":"Catheter Cardiovasc Interv"},{"key":"3526_CR21","first-page":"58","volume":"111","author":"S Gunta","year":"2012","unstructured":"Gunta S, Kamath S (2012) A case of pulmonary embolism and stroke in a 16-year-old girl. WMJ 111:58\u201360","journal-title":"WMJ"},{"key":"3526_CR22","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1007\/s12098-023-04645-2","volume":"90","author":"S He","year":"2023","unstructured":"He S, Zhang L, Liu XY, Ji XJ, Tang SL, Wu XY, Lu TW (2023) Cerebral infarction from sick sinus syndrome (Based on SCN5A) via patent foramen ovale. Ind J Pediatr. 90:836","journal-title":"Ind J Pediatr."},{"key":"3526_CR23","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1136\/thx.54.12.1139","volume":"54","author":"SD Playfor","year":"1999","unstructured":"Playfor SD, Smyth AR (1999) Paradoxical embolism in a boy with cystic fibrosis and a stroke. Thorax 54:1139\u20131140","journal-title":"Thorax"},{"issue":"1","key":"3526_CR24","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1016\/j.thromres.2014.03.021","volume":"133","author":"MF Whelihan","year":"2014","unstructured":"Whelihan MF, Lim MY, Key NS (2014) Red blood cells and thrombin generation in sickle cell disease. Thromb Res 133(1):S52-53","journal-title":"Thromb Res"},{"key":"3526_CR25","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1007\/s11239-021-02398-3","volume":"52","author":"C Aggeli","year":"2021","unstructured":"Aggeli C, Polytarchou K (2021) Stroke and presence of patent foramen ovale in sickle cell disease. J Thromb Thrombol 52:889\u2013897","journal-title":"J Thromb Thrombol"},{"key":"3526_CR26","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.761443","volume":"12","author":"NA Galadanci","year":"2021","unstructured":"Galadanci NA, Johnson W, Carson A, Hellemann G, Howard V, Kanter J (2021) Association between patent foramen ovale and overt ischemic stroke in children with sickle cell disease. Front Neurol 12:761443","journal-title":"Front Neurol"},{"key":"3526_CR27","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1111\/bjh.14391","volume":"176","author":"MM Dowling","year":"2017","unstructured":"Dowling MM, Quinn CT, Ramaciotti C, Kanter J, Osunkwo I, Inusa B, Iyer R, Kwiatkowski JL, Johnson C, Rhodes M, Owen W, Strouse JJ, Panepinto JA, Neumayr L, Sarnaik S, Plumb PA, Dlamini N, Kirkham F, Hynan LS (2017) Increased prevalence of potential right-to-left shunting in children with sickle cell anaemia and stroke. Br J Haematol 176:300\u2013308","journal-title":"Br J Haematol"},{"key":"3526_CR28","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1016\/j.jpeds.2009.10.012","volume":"156","author":"MM Dowling","year":"2010","unstructured":"Dowling MM, Lee N, Quinn CT, Rogers ZR, Boger D, Ahmad N, Ramaciotti C, Buchanan GR (2010) Prevalence of intracardiac shunting in children with sickle cell disease and stroke. J Pediatr 156:645\u2013650","journal-title":"J Pediatr"},{"key":"3526_CR29","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.pediatrneurol.2009.02.011","volume":"41","author":"MM Dowling","year":"2009","unstructured":"Dowling MM, Quinn CT, Rogers ZR, Journeycake JM (2009) Stroke in sickle cell anemia: alternative etiologies. Pediatr Neurol 41:124\u2013126","journal-title":"Pediatr Neurol"},{"key":"3526_CR30","doi-asserted-by":"publisher","first-page":"e29131","DOI":"10.1097\/MD.0000000000029131","volume":"101","author":"L Okar","year":"2022","unstructured":"Okar L, Ali Alzoubi H, Shukur Mahmud S, Elyas A, Yassin MA (2022) Dilemma in approach to stroke in sickle cell disease patient: a case report. Medicine (Baltimore) 101:e29131","journal-title":"Medicine (Baltimore)"},{"key":"3526_CR31","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1097\/00007632-200108010-00017","volume":"26","author":"RA Rodriguez","year":"2001","unstructured":"Rodriguez RA, Sinclair B, Weatherdon D, Letts M (2001) Patent foramen ovale and brain microembolization during scoliosis surgery in adolescents. Spine 26:1719\u20131721","journal-title":"Spine"},{"key":"3526_CR32","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1097\/00008506-199801000-00002","volume":"10","author":"G Fuchs","year":"1998","unstructured":"Fuchs G, Schwarz G, Stein J, Kaltenb\u00f6ck F, Baumgartner A, Oberbauer RW (1998) Doppler color-flow imaging: screening of a patent foramen ovale in children scheduled for neurosurgery in the sitting position. J Neurosurg Anesthesiol 10:5\u20139","journal-title":"J Neurosurg Anesthesiol"},{"key":"3526_CR33","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1017\/S1047951120003972","volume":"31","author":"M Ossa-Galvis","year":"2021","unstructured":"Ossa-Galvis M, Balaji S, Swaminathan S (2021) Patent foramen ovale: is it an incidental finding to ignore or a disease to follow? Cardiol Young 31:468\u2013470","journal-title":"Cardiol Young"},{"key":"3526_CR34","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1111\/head.13047","volume":"57","author":"A Ali","year":"2017","unstructured":"Ali A, Rothner AD (2017) Migraine with neurological features in a scuba diver with a patent foramen ovale. Headache 57:658\u2013662","journal-title":"Headache"},{"key":"3526_CR35","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1017\/S1047951121001396","volume":"31","author":"N Cetiner","year":"2021","unstructured":"Cetiner N, Uyan ZS, Celiker A (2021) Platypnea-orthodeoxia syndrome in a child: relief of symptoms after transcatheter closure of patent foramen ovale. Cardiol Young 31:1706\u20131708","journal-title":"Cardiol Young"},{"key":"3526_CR36","doi-asserted-by":"publisher","first-page":"e255","DOI":"10.1542\/peds.114.2.e255","volume":"114","author":"N Carano","year":"2004","unstructured":"Carano N, Agnetti A, Hagler DJ, Tchana B, Squarcia U, Bernasconi S (2004) Acute myocardial infarction in a child: possible pathogenic role of patent foramen ovale associated with heritable thrombophilia. Pediatrics 114:e255-258","journal-title":"Pediatrics"},{"key":"3526_CR37","first-page":"17","volume":"2018","author":"D Panagopoulos","year":"2018","unstructured":"Panagopoulos D, Loukopoulou S, Karanasios E, Grigoriadou G, Eleftherakis N (2018) Cerebral hemorrhagic infarction as the initial manifestation of deep venous thrombosis in a child with patent foramen ovale. Glob Cardiol Sci Pract 2018:17","journal-title":"Glob Cardiol Sci Pract"},{"key":"3526_CR38","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1111\/j.1469-8749.2004.tb00987.x","volume":"46","author":"L Filippi","year":"2004","unstructured":"Filippi L, Palermo L, Pezzati M, Dani C, Matteini M, De Cristofaro MT, Rubaltelli FF (2004) Paradoxical embolism in a preterm infant. Dev Med Child Neurol 46:713\u2013716","journal-title":"Dev Med Child Neurol"},{"key":"3526_CR39","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1510\/icvts.2007.155622","volume":"6","author":"F Loeffelbein","year":"2007","unstructured":"Loeffelbein F, Schlensak C, Beyersdorf F, Dittrich S (2007) Successful interventional closure of a patent foramen ovale in a pediatric patient supported with a biventricular assist device. Interact Cardiovasc Thorac Surg 6:778\u2013779","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"3526_CR40","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/BF00183764","volume":"11","author":"G Henry","year":"1996","unstructured":"Henry G, Walker P, Kern I (1996) Femoral artery embolus post-appendicectomy in a 12-year-old boy. Pediatr Surg Int 11:187\u2013188","journal-title":"Pediatr Surg Int"},{"key":"3526_CR41","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1016\/j.ejpn.2016.04.012","volume":"20","author":"R Khan","year":"2016","unstructured":"Khan R, Chan AK, Mondal TK, Paes BA (2016) Patent foramen ovale and stroke in childhood: a systematic review of the literature. Eur J Paediatr Neurol 20:500\u2013511","journal-title":"Eur J Paediatr Neurol"},{"key":"3526_CR42","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1161\/STROKEAHA.110.595876","volume":"42","author":"Z Hubail","year":"2011","unstructured":"Hubail Z, Lemler M, Ramaciotti C, Moore J, Ikemba C (2011) Diagnosing a patent foramen ovale in children: is transesophageal echocardiography necessary? Stroke 42:98\u2013101","journal-title":"Stroke"},{"key":"3526_CR43","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1002\/ccd.21440","volume":"70","author":"LA Latson","year":"2007","unstructured":"Latson LA (2007) Patent foramen ovale - \u201cback door\u201d to the brain, even in kids. Catheter Cardiovasc Interv 70:1008\u20131009","journal-title":"Catheter Cardiovasc Interv"},{"key":"3526_CR44","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1002\/ccd.21492","volume":"71","author":"D Kenny","year":"2008","unstructured":"Kenny D, Turner M, Martin R (2008) PFO closure in children. Cathet Cardio Interv 71:715","journal-title":"Cathet Cardio Interv"},{"key":"3526_CR45","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1212\/WNL.0000000000009443","volume":"94","author":"SR Mess\u00e9","year":"2020","unstructured":"Mess\u00e9 SR, Gronseth GS, Kent DM, Kizer JR, Homma S, Rosterman L, Carroll JD, Ishida K, Sangha N, Kasner SE (2020) Practice advisory update summary: patent foramen ovale and secondary stroke prevention: report of the guideline subcommittee of the American Academy of Neurology. Neurology 94:876\u2013885","journal-title":"Neurology"},{"issue":"1389","key":"3526_CR46","first-page":"1402","volume":"14","author":"C Pristipino","year":"2019","unstructured":"Pristipino C, Sievert H, D\u2019Ascenzo F, Mas JL, Meier B, Scacciatella P, Hildick-Smith D, Gaita F, Toni D, Kyrle P, Thomson J, Derumeaux G, Onorato E, Sibbing D, Germonpr\u00e9 P, Berti S, Chessa M, Bedogni F, Dudek D, Hornung M, Zamorano J (2019) European position paper on the management of patients with patent foramen ovale General approach and left circulation thromboembolism. EuroIntervention 14(1389):1402","journal-title":"EuroIntervention"},{"key":"3526_CR47","doi-asserted-by":"publisher","first-page":"e737S","DOI":"10.1378\/chest.11-2308","volume":"141","author":"P Monagle","year":"2012","unstructured":"Monagle P, Chan AKC, Goldenberg NA, Ichord RN, Journeycake JM, Nowak-G\u00f6ttl U, Vesely SK (2012) Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest 141:e737S-e801S","journal-title":"Chest"},{"key":"3526_CR48","doi-asserted-by":"publisher","first-page":"2622","DOI":"10.1161\/01.cir.0000436140.77832.7a","volume":"128","author":"TM Giglia","year":"2013","unstructured":"Giglia TM, Massicotte MP, Tweddell JS, Barst RJ, Bauman M, Erickson CC, Feltes TF, Foster E, Hinoki K, Ichord RN, Kreutzer J, McCrindle BW, Newburger JW, Tabbutt S, Todd JL, Webb CL (2013) Prevention and treatment of thrombosis in pediatric and congenital heart disease: a scientific statement from the American Heart Association. Circulation 128:2622\u20132703","journal-title":"Circulation"},{"key":"3526_CR49","doi-asserted-by":"publisher","first-page":"e51","DOI":"10.1161\/STR.0000000000000183","volume":"50","author":"DM Ferriero","year":"2019","unstructured":"Ferriero DM, Fullerton HJ, Bernard TJ, Billinghurst L, Daniels SR, DeBaun MR, deVeber G, Ichord RN, Jordan LC, Massicotte P, Meldau J, Roach ES, Smith ER (2019) Management of Stroke in Neonates and Children: a scientific statement from the American Heart Association\/American Stroke Association. Stroke 50:e51\u2013e96","journal-title":"Stroke"},{"key":"3526_CR50","doi-asserted-by":"publisher","first-page":"44","DOI":"10.4103\/apc.apc_67_21","volume":"15","author":"S Saharan","year":"2022","unstructured":"Saharan S, Vettukattil J, Bhat A, Amula V, Bansal M, Chowdhury D, Dyamenahalli U, Gupta SK, Das B, Susheel Kumar TK, Muralidaran A, Trivedi K, Swaminathan S, Bansal N, Doshi U, Hoskoppal A, Balaji S (2022) Patent foramen ovale in children: unique pediatric challenges and lessons learned from adult literature. Ann Pediatr Cardiol 15:44\u201352","journal-title":"Ann Pediatr Cardiol"}],"container-title":["Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-024-03526-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00246-024-03526-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-024-03526-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T13:02:36Z","timestamp":1745499756000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00246-024-03526-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":50,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["3526"],"URL":"https:\/\/doi.org\/10.1007\/s00246-024-03526-5","relation":{},"ISSN":["0172-0643","1432-1971"],"issn-type":[{"value":"0172-0643","type":"print"},{"value":"1432-1971","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,1]]},"assertion":[{"value":"26 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}