Abstract 14250: Incidence of Provoked Exercise Desaturation in Patent Foramen Ovale and Impact of Percutaneous Closure
Introduction: Platypnea-orthodeoxia is a well described but uncommon phenomenon in patients with patent foramen ovale (PFO). In PFO patients with dyspnea, however, we have more commonly witnessed oxygen desaturation during exertion or provoked exercise desaturation (PED). This prospective study was designed to examine the incidence of this phenomenon in a referral population and to assess the impact of PFO closure.
Hypothesis: We hypothesize that PFO closure will reduce the prevalence of PED.
Methods: This was a single-center prospective study of 50 consecutive patients with recently diagnosed PFO. Each patient underwent a standardized evaluation for arterial oxygen desaturation using pulse oximetry during postural changes and exercise. Exercise consisted of ambulation up and down 4 flights of stairs. PED was defined as a desaturation of at least 8% to a value less than 90%. All PED patients who underwent PFO closure were reevaluated (echo and repeat stair testing) three months post-procedure.
Results: Mean age of the cohort was 46 ± 17 years, 74% were female, 30% had migraines, and 48% had experienced a cerebrovascular event. 17 patients (34%) demonstrated PED, and these patients were demographically similar to patients who did not demonstrate PED. Ten PED patients underwent PFO closure (2 surgical and 8 percutaneous). Drop in oxygen saturation was improved by an average of 10.1±4.2% following closure (p<0.001). NYHA function class also improved by an average of 1.3±0.8 to (p<0.001).
Conclusions: A third of patients referred for assessment of PFO have oxygen desaturation during stair exercise. Closure of PFO in these patients ameliorates this phenomenon and improves function class.
- © 2011 by American Heart Association, Inc.