{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:47:18Z","timestamp":1790790438446,"version":"4.1.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T00:00:00Z","timestamp":1530144000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Cardiovasc Imaging"],"published-print":{"date-parts":[[2018,12]]},"DOI":"10.1007\/s10554-018-1406-1","type":"journal-article","created":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T04:21:56Z","timestamp":1530159716000},"page":"1849-1861","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Echocardiographic features of PFOs and paradoxical embolism: a complicated puzzle"],"prefix":"10.1007","volume":"34","author":[{"given":"Constantina","family":"Aggeli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Verveniotis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathia","family":"Andrikopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Vavuranakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstadinos","family":"Toutouzas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Tousoulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,6,28]]},"reference":[{"issue":"9","key":"1406_CR1","doi-asserted-by":"publisher","first-page":"1768","DOI":"10.1016\/j.jacc.2005.08.038","volume":"46","author":"H Hara","year":"2005","unstructured":"Hara H, Virmani R, Ladich E et al (2005) Patent foramen ovale: current pathology, pathophysiology, and clinical status. J Am Coll Cardiol 46(9):1768\u20131776","journal-title":"J Am Coll Cardiol"},{"key":"1406_CR2","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.ejim.2015.09.017","volume":"26","author":"M Mojadidi","year":"2015","unstructured":"Mojadidi M, Christia P, Salamon J et al (2015) Patent foramen ovale: unanswered questions. Eur J Intern Med 26:743\u2013751","journal-title":"Eur J Intern Med"},{"issue":"19","key":"1406_CR3","doi-asserted-by":"publisher","first-page":"1665","DOI":"10.1016\/j.jacc.2011.09.085","volume":"59","author":"S Kutty","year":"2012","unstructured":"Kutty S, Sengupta PP, Khandheria BK (2012) Patent foramen ovale the known and the to be known. J Am Coll Cardiol 59(19):1665\u20131671","journal-title":"J Am Coll Cardiol"},{"issue":"6","key":"1406_CR4","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1016\/j.jjcc.2016.01.013","volume":"67","author":"F Pizzino","year":"2016","unstructured":"Pizzino F, Khandheria B, Carerj S et al (2016) PFO: button me up, but wait\u2026comprehensive evaluation of the patient. J Cardiol 67(6):485\u2013492","journal-title":"J Cardiol"},{"issue":"5","key":"1406_CR5","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1002\/ccd.26993","volume":"90","author":"SE Hardt","year":"2017","unstructured":"Hardt SE, Eicken A, Berger F et al (2017) Closure of patent foramen ovale defects using GORE\u00ae CARDIOFORM septal occluder: results from a prospective European multicenter study. Catheter Cardiovasc Interv 90(5):824\u2013829","journal-title":"Catheter Cardiovasc Interv"},{"key":"1406_CR6","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1056\/NEJMoa1707404","volume":"377","author":"L S\u00f8ndergaar","year":"2017","unstructured":"S\u00f8ndergaar L, Kasner SE, Rhodes JF, for the Gore REDUCE Clinical Study Investigators et al (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":"1406_CR7","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1056\/NEJMoa1705915","volume":"377","author":"J-L Mas","year":"2017","unstructured":"Mas J-L, Derumeaux G, Guillon B for the CLOSE Investigators et al (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":"1406_CR8","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 for the RESPECT Investigators et al (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"},{"issue":"3","key":"1406_CR9","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1111\/echo.12360","volume":"31","author":"N Bhatia","year":"2014","unstructured":"Bhatia N, Abushora MY, Donneyong MM et al (2014) Determination of the optimum number of cardiac cycles to differentiate intra-pulmonary shunt and patent foramen ovale by saline contrast two- and three-dimensional echocardiography. Echocardiography 31(3):293\u2013301","journal-title":"Echocardiography"},{"issue":"4","key":"1406_CR10","first-page":"495","volume":"6","author":"AN Mahmoud","year":"2017","unstructured":"Mahmoud AN, Elgendy IY, Agarwal N et al (2017) Identification and quantification of patent foramen ovale- mediated shunts: echocardiography and transcranial Doppler. Interv Cardiol Clin 6(4):495\u2013504","journal-title":"Interv Cardiol Clin"},{"key":"1406_CR11","doi-asserted-by":"publisher","first-page":"910958","DOI":"10.1016\/j.echo.2015.05.015","volume":"28","author":"FE Silvestry","year":"2015","unstructured":"Silvestry FE, Cohen MS, Armsby LB et al (2015) Guidelines for the echocardiographic assessment of atrial septal defect and patent foramen ovale: from the American Society of Echocardiography and Society for Cardiac Angiography and Interventions.; American Society of Echocardiography; Society for Cardiac Angiography and Interventions. J Am Soc Echocardiogr 28:910\u2013958","journal-title":"J Am Soc Echocardiogr"},{"issue":"12","key":"1406_CR12","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1056\/NEJMoa1301440","volume":"368","author":"JD Carroll","year":"2013","unstructured":"Carroll JD, Saver JL, Thaler DE RESPECT Investigators et al (2013) Closure of patent foramen ovale versus medical therapy after cryptogenic stroke. N Engl J Med 368(12):1092\u20131100","journal-title":"N Engl J Med"},{"issue":"6","key":"1406_CR13","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/S0894-7317(97)70027-0","volume":"10","author":"A Olivares-Reyes","year":"1997","unstructured":"Olivares-Reyes A, Chan S, Lazar EJ et al (1997) Atrial septal aneurysm: a new classification in two hundred five adults. J Am Soc Echocardiogr 10(6):644\u2013656","journal-title":"J Am Soc Echocardiogr"},{"issue":"5","key":"1406_CR14","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/ccd.26357","volume":"89","author":"Y Kijima","year":"2015","unstructured":"Kijima Y, Bokhoor P (2015) Patent foramen ovale with right atrial septal pouch. Catheter Cardiovasc Interv 89(5):169\u2013171","journal-title":"Catheter Cardiovasc Interv"},{"issue":"1","key":"1406_CR15","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.amjcard.2010.02.025","volume":"106","author":"JY Lee","year":"2010","unstructured":"Lee JY, Song JK, Song JM et al (2010) Association between anatomic features of atrial septal abnormalities obtained by omni-plane transesophageal echocardiography and stroke recurrence in cryptogenic stroke patients with patent foramen ovale. Am J Cardiol 106(1):129\u2013134","journal-title":"Am J Cardiol"},{"issue":"1","key":"1406_CR16","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.amjcard.2008.08.036","volume":"103","author":"SS Goel","year":"2009","unstructured":"Goel SS, Tuzcu EM, Shishehbor MH et al (2009) Morphology of the patent foramen ovale in asymptomatic versus symptomatic (stroke or transient ischemic attack) patients. Am J Cardiol 103(1):124\u2013129","journal-title":"Am J Cardiol"},{"issue":"6","key":"1406_CR17","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1007\/s00415-011-6297-1","volume":"259","author":"T Fukuoka","year":"2012","unstructured":"Fukuoka T, Dembo T, Nagoya H et al (2012) Factors related to recurrence of paradoxical cerebral embolism due to patent foramen ovale. J Neurol 259(6):1051\u20131055","journal-title":"J Neurol"},{"issue":"2","key":"1406_CR18","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/j.jacc.2005.10.044","volume":"47","author":"I Meissner","year":"2006","unstructured":"Meissner I, Khandheria BK, Heit JA et al (2006) Patent foramen ovale: innocent or guilty? Evidence from a prospective population-based study. J Am Coll Cardiol 47(2):440\u2013445","journal-title":"J Am Coll Cardiol"},{"issue":"10","key":"1406_CR19","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1093\/ejechocard\/jeq122","volume":"11","author":"BS Rana","year":"2010","unstructured":"Rana BS, Shapiro LM, McCarthy KP (2010) Three-dimensional imaging of the atrial septum and patent foramen ovale anatomy: defining the morphological phenotypes of patent foramen ovale. Eur J Echocardiogr 11(10):19\u201325","journal-title":"Eur J Echocardiogr"},{"issue":"12","key":"1406_CR20","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1093\/ehjci\/jeu143","volume":"15","author":"A Vitarelli","year":"2014","unstructured":"Vitarelli A, Mangieri E, Capotosto L et al (2014) Echocardiographic findings in simple and complex patent foramen ovale before and after transcatheter closure. Eur Heart J Cardiovasc Imaging 15(12):1377\u20131385","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"11","key":"1406_CR21","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1016\/j.jcin.2013.06.013","volume":"6","author":"I Inglessis","year":"2013","unstructured":"Inglessis I, Elmariah S, Rengifo-Moreno PA et al (2013) Long-term experience and outcomes with transcatheter closure of patent foramen ovale. JACC Cardiovasc Interv 6(11):1176\u20131183","journal-title":"JACC Cardiovasc Interv"},{"issue":"8","key":"1406_CR22","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1016\/j.jacc.2015.12.023","volume":"67","author":"DM Kent","year":"2016","unstructured":"Kent DM, Dahabreh IJ, Ruthazer R et al (2016) Device Closure of patent foramen ovale after stroke pooled analysis of completed randomized trials. J Am Coll Cardiol 67(8):907\u2013917","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"1406_CR23","doi-asserted-by":"publisher","first-page":"2160","DOI":"10.1161\/STR.0000000000000024","volume":"45","author":"WN Kernan","year":"2014","unstructured":"Kernan WN, Ovbiagele B, Black HR et al (2014) Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association. Stroke 45(7):2160\u20132236","journal-title":"Stroke"},{"issue":"7","key":"1406_CR24","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1212\/WNL.0b013e3182a08d59","volume":"81","author":"DM Kent","year":"2013","unstructured":"Kent DM, Ruthazer R, Weimar C et al (2013) An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke. Neurology 81(7):619\u2013625","journal-title":"Neurology"},{"issue":"3","key":"1406_CR25","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1111\/ene.12897","volume":"23","author":"AH Katsanos","year":"2016","unstructured":"Katsanos AH, Giannopoulos S, Frogoudaki A et al (2016) The diagnostic yield of transesophageal echocardiography in patients with cryptogenic cerebral ischaemia: a meta-analysis. Eur J Neurol 23(3):569\u2013579","journal-title":"Eur J Neurol"},{"issue":"2","key":"1406_CR26","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1093\/eurheartj\/ehu292","volume":"36","author":"S Stortecky","year":"2015","unstructured":"Stortecky S, da Costa BR, Mattle HP et al (2015) Percutaneous closure of patent foramen ovale in patients with cryptogenic embolism: a network meta-analysis. Eur Heart J 36(2):120\u2013128","journal-title":"Eur Heart J"},{"issue":"11","key":"1406_CR27","doi-asserted-by":"publisher","first-page":"3352","DOI":"10.1161\/STROKEAHA.114.007109","volume":"45","author":"AH Katsanos","year":"2014","unstructured":"Katsanos AH, Spence JD, Bogiatzi C et al (2014) Recurrent stroke and patent foramen ovale: a systematic review and meta-analysis. Stroke 45(11):3352\u20133359","journal-title":"Stroke"},{"key":"1406_CR28","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1016\/j.jacc.2006.08.063","volume":"49","author":"M Tullio Di","year":"2007","unstructured":"Di Tullio M, Sacco R, Sciacca R,et al (2007) Patent foramen ovale and the risk of ischemic stroke in a multiethnic population. J Am Coll Cardiol 49:797\u2013802","journal-title":"J Am Coll Cardiol"},{"issue":"11","key":"1406_CR29","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1056\/NEJMoa1009639","volume":"366","author":"AJ Furlan","year":"2012","unstructured":"Furlan AJ, Reisman M, Massaro J CLOSURE I Investigators et al (2012) Closure or medical therapy for cryptogenic stroke with patent foramen ovale. N Engl J Med 366(11):991\u2013999","journal-title":"N Engl J Med"},{"issue":"12","key":"1406_CR30","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1056\/NEJMoa1211716","volume":"368","author":"B Meier","year":"2013","unstructured":"Meier B, Kalesan B, Mattle HP, PC Trial Investigators et al (2013) Percutaneous closure of patent foramen ovale in cryptogenic embolism. N Engl J Med 368(12):1083\u20131091","journal-title":"N Engl J Med"},{"key":"1406_CR31","unstructured":"Brauser D (2015) RESPECT 10-year data strengthens case for PFO closure after cryptogenic stroke. Medscape. Available at \n                    http:\/\/www.medscape.com\/viewarticle\/852810\n                    \n                  . Accessed 29 Dec 2015"},{"key":"1406_CR32","unstructured":"http:\/\/www.tctmd.com\/news\/final-respect-data-support-pfo-closure-cryptogenic-stroke-prevention"},{"issue":"8","key":"1406_CR33","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1212\/WNL.0000000000002961","volume":"87","author":"SR Mess\u00e9","year":"2016","unstructured":"Mess\u00e9 SR, Gronseth G, Kent DM et al (2016) Practice advisory: recurrent stroke with patent foramen ovale (update of practice parameter), Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 87(8):815\u2013821","journal-title":"Neurology"},{"issue":"11","key":"1406_CR34","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1056\/NEJMe1709637","volume":"377","author":"AH Ropper","year":"2017","unstructured":"Ropper AH (2017) Tipping point for patent foramen ovale closure. N Engl J Med 377(11):1093\u20131095","journal-title":"N Engl J Med"},{"issue":"11","key":"1406_CR35","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1056\/NEJMp1700218","volume":"377","author":"A Farb","year":"2017","unstructured":"Farb A, Ibrahim NG, Zuckerman BD (2017) Patent foramen ovale after cryptogenic stroke\u2014assessing the evidence for closure. N Engl J Med 377(11):1006\u20131100","journal-title":"N Engl J Med"},{"key":"1406_CR36","unstructured":"http:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm527096.htm"},{"issue":"5","key":"1406_CR37","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1159\/000131083","volume":"25","author":"European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee","year":"2008","unstructured":"European Stroke Organisation(ESO) Executive Committee; ESO Writing Committee (2008) Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis 25(5):457\u2013507","journal-title":"Cerebrovasc Dis"},{"issue":"26","key":"1406_CR38","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1093\/eurheartj\/ehv376","volume":"37","author":"F Nietlispach","year":"2016","unstructured":"Nietlispach F, Meier B (2016) Percutaneous closure of patent foramen ovale: an underutilized prevention? Eur Heart J 37(26):2023\u20132028","journal-title":"Eur Heart J"},{"issue":"18","key":"1406_CR39","doi-asserted-by":"publisher","first-page":"1722","DOI":"10.1016\/j.jacc.2012.01.086","volume":"60","author":"J Tobis","year":"2012","unstructured":"Tobis J, Shenoda M (2012) Percutaneous treatment of patent foramen ovale and atrial septal defects. J Am Coll Cardiol 60(18):1722\u20131732","journal-title":"J Am Coll Cardiol"}],"container-title":["The International Journal of Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s10554-018-1406-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10554-018-1406-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10554-018-1406-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T19:08:41Z","timestamp":1561662521000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s10554-018-1406-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,28]]},"references-count":39,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["1406"],"URL":"https:\/\/doi.org\/10.1007\/s10554-018-1406-1","relation":{},"ISSN":["1569-5794","1573-0743"],"issn-type":[{"value":"1569-5794","type":"print"},{"value":"1573-0743","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,28]]},"assertion":[{"value":"13 February 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 June 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}