Table 2.

Key points in the review.

Key point	Conclusion/review of literature	References
Is insertion of atrial septum devices in PFO to avoid cryptogenic stroke beneficial compared to anticoagulation or open heart surgery?	The efficacy of PFO closure devices has not been proven in any published trial	(21–24,26,36–49,73–78)
Is the position controlled with TEE before or after insertion?	The positions are rarely controlled with TEE before or after insertion	(26–27,30–33)
What is the complication rate?	Residual shunts can be demonstrated in up to 45% of cases	(30–33,41–44)
Is the rate of post-arrhythmic complications known?	The rate of post-arrhythmic complications increases, especially AF, recently concluded as an underdiagnosed and hence increasingly important cause of cryptogenic strokes	(30,40,41,58–60,62,63)
Is the risk of AF in patients with PFO increased?	(Considering PFO as a congenital heart disease) the risk of AF in congenital heart disease is increasing with increasing age, with a 13% risk of TIAs and stroke	(65–72)
How should we treat patients with cryptogenic stroke and PFO?	Literature points towards surgery as evident treatment of congenital heart defects including PFO causing AF	(2,3,36–49,73–80)