Clinical relevance of atrial septal aneurysm and patent foramen ovale with migraine

• Published in: World journal of clinical cases 2018-12, Vol.6 (15), p.916-921
• Main Authors: He, Lu, Cheng, Ge-Sheng, Du, Ya-Juan, Zhang, Yu-Shun
• Format: Article
• Language: English
• Subjects: Case Control Study
• ISSN: 2307-8960; 2307-8960
• DOI: 10.12998/wjcc.v6.i15.916

To test the potential association between atrial septal aneurysm (ASA) and migraine in patent foramen ovale (PFO) closure patients through an observational, single-center, case-controlled study. We studied a total of 450 migraineurs who had right-to-left shunts and underwent PFO closure in a retrospective single-center non-randomized registry from February 2012 to October 2016 on the condition that they were aged 18-45 years old. Migraine was diagnosed according to the International Classification of Headache Disorders, 3 edition and evaluated using the Headache Impact Test-6 (HIT-6). All patients underwent preoperative transesophageal echocardiography, contrast transthoracic echocardiography, and computed tomography or magnetic resonance imaging examinations, with subsequent fluoroscopy-guided PFO closure. Based on whether they have ASA or not, the patients were divided into two groups: A (PFO with ASA, = 80) and B (PFO without ASA, = 370). Baseline characteristics and procedural and follow-up data were reviewed. Compared to group B, group A had an increased frequency of ischemic lesions (11.3% 6.2%, = 0.038) and migraine with aura (32.5% 21.1%, = 0.040). The PFO size was significantly larger in group A ( = 0.007). There was no significant difference in HIT-6 scores between the two groups before and at the one-year follow-up after the PFO closure [61 (9) 63 (9), = 0.227; 36 (13) 36 (10), = 0.706]. Despite its small sample size, our study suggests that the prevalence of ASA in PFO with migraine patients is associated with ischemic stroke, larger PFO size, and migraine with aura.