Shortened dual anti-platelet therapy duration after percutaneous patent foramen ovale and atrial septal defect closure.

Objectives: Current guidelines recommend patent foramen ovale (PFO) closure in patients with cryptogenic stroke, while atrial septal defect (ASD) closure is indicated for a shunt with right atrial/right ventricular (RV) enlargement. Major procedural complication rates from PFO/ASD closure are low. However, there is a theoretical risk of thrombus formation early after implantation, prior to endothelialization of the device, that may be prevented by dual antiplatelet therapy (DAPT). There is little data on the optimal timing and duration of DAPT post-device placement; thus, this study aimed to evaluate the safety of shortened DAPT after PFO/ASD closure with respect to device thrombosis and clinical stroke.

Methods: One hundred ninety-four patients 18 years or older who underwent transcatheter PFO/ASD closure from 2010 to 2021 were included in the study. The primary outcome was the rate of device thrombosis at 1 year. The secondary outcome was stroke and peripheral embolization at 1 year.

Results: Closures were primarily performed for cryptogenic stroke (41.9%) and ASD closure for RV enlargement (26.9%). The average length of DAPT was 2.91 ± 2.6 months. At 1 year, there were no cases of device thrombosis or embolization.

Conclusions: This study suggests that 3 months or less of DAPT may be safe in patients after percutaneous PFO/ASD closure.