Pulmonary vascular hemodynamics in patients undergoing percutaneous closure of a patent foramen ovale

Background The pulmonary hemodynamics of otherwise healthy patients with a persistent foramen ovale (PFO) have not yet been sufficiently characterized. Methods Between September 1998 and July 2017, all patients who underwent percutaneous PFO closure were examined using right heart catheterization (RHC). We retrospectively collected demographic, clinical, and hemodynamic data from these patients. Exclusion criteria included being under 18 years of age, lacking a digital medical record, having relevant comorbidities, or possessing an incomplete RHC dataset. A dataset was considered incomplete if either the mean pulmonary arterial pressure (mPAP), left atrial pressure (LAP), or pulmonary vascular resistance (PVR) was missing. Results A total of 1,017 PFO patients were screened, of whom 546 met the inclusion criteria. The mPAP was 17.4 ± 4.1 mmHg, the LAP was 8.9 ± 3.8 mmHg, and the PVR was 2.4 ± 1.4 WU. Female patients had significantly higher mPAP values (female: 18.0 ± 5.7 mmHg; male: 16.7 ± 4.2 mmHg, P = 0.002) as well as higher PVR values (female: 2.6 ± 1.6 WU; male: 1.9 ± 1.1 WU, P < 0.001). A linear regression analysis showed a significant positive correlation between mPAP and age (R² = 0.08, P < 0.001). Conclusion Compared to reference values for healthy individuals (mPAP 14 ± 3 mmHg and PVR 0.9 ± 0.4 WU), our data indicate slightly elevated pulmonary pressure levels and resistance in PFO patients undergoing percutaneous closure. We observed an increase in mPAP with age and higher pulmonary hemodynamic values in the female patients of our cohort. Whether these findings are generalizable to all PFO patients or represent a potential risk factor for paradoxical embolism leading to PFO diagnosis in this cohort remains unclear.