Evidence map›Paper›PMID 32422058›Full record

ArticleAnnals of internal medicine2020

Residual Shunt After Patent Foramen Ovale Closure and Long-Term Stroke Recurrence: A Prospective Cohort Study.

Wenjun Deng, Shanye Yin, David McMullin, Ignacio Inglessis-Azuaje, Sammy Elmariah, Judy Hung, Eng H Lo, Igor F Palacios, Ferdinando S Buonanno, MingMing Ning

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07724171 (Long-term Clinical Outcomes and Prognostic Factors After Percutaneous Patent Foramen Ovale Closure), which is not on this map. Cited by 41 papers.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed
4.6field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07724171 recruitingnot on this mapstarted 2026, after this paper: background citation

Long-term Clinical Outcomes and Prognostic Factors After Percutaneous Patent Foramen Ovale Closure: A Retrospective Cohort Study With Prospective Registry Extension

TypeobservationalSponsorYonsei UniversityRan2026 to 2036Enrolled400ConditionsPatent Foramen Ovale, Cryptogenic Stroke, Transient Ischemic Attack Due to Embolism, Atrial Fibrillation
3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 69 citations in OpenAlex.

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  14. Percutaneous closure of patent foramen ovale with complex anatomy using the Memopart™ occluder device.American heart journal plus : cardiology research and practice · 2025
    Article
  15. Experimental Study of the TAI QINGActa Cardiologica Sinica · 2025
    Article
  16. Article
  17. Prevalence, classification, and treatment of residual shunt after patent foramen ovale closure.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Wenjun DengMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
Shanye YinMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
David McMullinMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
Ignacio Inglessis-AzuajeMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
Sammy ElmariahMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
Judy HungMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
Eng H LoMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
Igor F PalaciosMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
Ferdinando S BuonannoMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
MingMing NingMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).
Harvard University · USMassachusetts General Hospital · US

Funding

Proteomic Profiling of Patent Foramen Ovale Related Neurovascular InjuryR01NS067139 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI NING, MINGMING · 2010 to 2023
$3.7M
Thrombolysis Profiles in tPA ResponseR01NS093415 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI LO, ENG H., NING, MINGMING · 2015 to 2019
$1.9M
Glycoproteomics in Ischemic Stroke Related HyperglycemiaR21NS113065 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI NING, MINGMING · 2020 to 2020
$462k
Proteomic Profile of Brain Endothelial Cell in HypoxiaR21NS052498 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI NING, MINGMING · 2005 to 2006
$439k
NINDS NIH HHS R01 NS067139NINDS NIH HHS R01 NS093415NINDS NIH HHS R21 NS052498NINDS NIH HHS R21 NS113065
6 · The paper itself

Abstract

backgroundResidual shunt is observed in up to 25% of patients after patent foramen ovale (PFO) closure, but its long-term influence on stroke recurrence currently is unknown.

objectiveTo investigate the association of residual shunt after PFO closure with the incidence of recurrent stroke and transient ischemic attack (TIA).

designProspective cohort study comparing stroke or TIA recurrence in patients with and without residual shunt after PFO closure.

settingSingle hospital center.

participants1078 consecutive patients (mean age, 49.3 years) with PFO-attributable cryptogenic stroke who were undergoing percutaneous PFO closure were followed for up to 11 years. MEASUREMENTS: Residual shunt was evaluated by transthoracic echocardiography with saline contrast. Primary outcome was a composite of the first recurrent ischemic stroke or TIA after PFO closure.

resultsCompared with complete closure, the presence of residual shunt after PFO closure was associated with an increased incidence of recurrent stroke or TIA: 2.32 versus 0.75 events per 100 patient-years (hazard ratio [HR], 3.05 [95% CI, 1.65 to 5.62]; LIMITATION: Nonrandomized study with potential unmeasured confounding.

conclusionAmong patients undergoing PFO closure to prevent future stroke, the presence of residual shunt, particularly a moderate or large residual shunt, was associated with an increased risk for stroke or TIA recurrence. PRIMARY FUNDING SOURCE: National Institutes of Health.

Indexed as

EchocardiographyFemaleForamen Ovale, PatentHumansIschemic Attack, TransientMaleMiddle AgedProspective StudiesRecurrenceStrokeAneurysmsEchocardiographyFactor analysisHyperlipidemiaHypertensionIschemic strokeLongitudinal studiesMedical risk factorsStrokeTransient ischemic attacks

Identifiers

PMID32422058
PMCPMC10021023
OpenAlexW3110891447

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.