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Persistent foramen ovale closure in divers with a history of decompression sickness
OBJECTIVE: To study the effect of percutaneous patent foramen ovale (PFO) closure in divers with a history of decompression sickness (DCS). STUDY DESIGN: (1) Retrospective study of patient records and (2) telephonic follow-up. Patients with unexplained decompression sickness, who were referred to a ...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bohn Stafleu van Loghum
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220018/ https://www.ncbi.nlm.nih.gov/pubmed/30178210 http://dx.doi.org/10.1007/s12471-018-1153-x |
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author | Koopsen, R. Stella, P. R. Thijs, K. M. Rienks, R. |
author_facet | Koopsen, R. Stella, P. R. Thijs, K. M. Rienks, R. |
author_sort | Koopsen, R. |
collection | PubMed |
description | OBJECTIVE: To study the effect of percutaneous patent foramen ovale (PFO) closure in divers with a history of decompression sickness (DCS). STUDY DESIGN: (1) Retrospective study of patient records and (2) telephonic follow-up. Patients with unexplained decompression sickness, who were referred to a cardiologist with a focus on diving medicine between 2000 and 2017, were included in the study RESULTS: A total of 62 divers with DCS were included. In all cases transoesophageal echocardiography (TEE) was performed, showing 29 PFOs and 6 atrial septum defects (ASDs) in total n = 35 (56%). The highest prevalence was found in divers with cutaneous and vestibular DCS. At follow-up (mean follow-up duration 6.8 years), 21 PFOs/ASDs were closed using a percutaneous procedure. One diver was lost to follow-up. One diver quit diving. The remaining divers were able to resume unrestricted diving; there was no recurrence of major DCS. Of the divers with an open PFO or ASD, 14 were included of whom 7 are currently diving. All (except one diver with a small PFO) divers are using a conservative diving profile to reduce nitrogen load and the appearance of venous nitrogen bubbles. There was no recurrence of major DCS in this group. CONCLUSION: Percutaneous PFO closure may be an effective and safe treatment for divers who have suffered a major DCS to return to unrestricted diving. Alternatively, conservative treatment seems safe when divers refrain from unrestricted diving and use a conservative technique in order to reduce nitrogen load. |
format | Online Article Text |
id | pubmed-6220018 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-62200182018-11-16 Persistent foramen ovale closure in divers with a history of decompression sickness Koopsen, R. Stella, P. R. Thijs, K. M. Rienks, R. Neth Heart J Original Article OBJECTIVE: To study the effect of percutaneous patent foramen ovale (PFO) closure in divers with a history of decompression sickness (DCS). STUDY DESIGN: (1) Retrospective study of patient records and (2) telephonic follow-up. Patients with unexplained decompression sickness, who were referred to a cardiologist with a focus on diving medicine between 2000 and 2017, were included in the study RESULTS: A total of 62 divers with DCS were included. In all cases transoesophageal echocardiography (TEE) was performed, showing 29 PFOs and 6 atrial septum defects (ASDs) in total n = 35 (56%). The highest prevalence was found in divers with cutaneous and vestibular DCS. At follow-up (mean follow-up duration 6.8 years), 21 PFOs/ASDs were closed using a percutaneous procedure. One diver was lost to follow-up. One diver quit diving. The remaining divers were able to resume unrestricted diving; there was no recurrence of major DCS. Of the divers with an open PFO or ASD, 14 were included of whom 7 are currently diving. All (except one diver with a small PFO) divers are using a conservative diving profile to reduce nitrogen load and the appearance of venous nitrogen bubbles. There was no recurrence of major DCS in this group. CONCLUSION: Percutaneous PFO closure may be an effective and safe treatment for divers who have suffered a major DCS to return to unrestricted diving. Alternatively, conservative treatment seems safe when divers refrain from unrestricted diving and use a conservative technique in order to reduce nitrogen load. Bohn Stafleu van Loghum 2018-09-03 2018-11 /pmc/articles/PMC6220018/ /pubmed/30178210 http://dx.doi.org/10.1007/s12471-018-1153-x Text en © The Author(s) 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Koopsen, R. Stella, P. R. Thijs, K. M. Rienks, R. Persistent foramen ovale closure in divers with a history of decompression sickness |
title | Persistent foramen ovale closure in divers with a history of decompression sickness |
title_full | Persistent foramen ovale closure in divers with a history of decompression sickness |
title_fullStr | Persistent foramen ovale closure in divers with a history of decompression sickness |
title_full_unstemmed | Persistent foramen ovale closure in divers with a history of decompression sickness |
title_short | Persistent foramen ovale closure in divers with a history of decompression sickness |
title_sort | persistent foramen ovale closure in divers with a history of decompression sickness |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220018/ https://www.ncbi.nlm.nih.gov/pubmed/30178210 http://dx.doi.org/10.1007/s12471-018-1153-x |
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