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To the Editor: Percutaneous closure of patent foramen ovale/atrial septal defect (PFO/ASD) is perceived as having minimal risk and has been proposed for a broad array of indications.¹ The widespread application of this procedure, especially PFO closure, is controversial because of limited data on its efficacy and safety in many settings, including prevention of recurrent cryptogenic stroke.² We studied trends in the prevalence of PFO/ASD closure in the United States.

Methods

We analyzed data from 1998 through 2004 of the Nationwide Inpatient Sample, the largest publicly available all-payer US inpatient database; this stratified sample approximates a 20% sample of US community hospitals. The Hospital of the University of Pennsylvania institutional review board granted an exemption for this study.

The cohort included participants aged 20 years or older with a procedure code from the International Classification of Diseases, Ninth Revision (ICD-9) designating "Repair of ASD with prosthesis, closed technique" (. . . [Full Text of this Article]

Alexander R. Opotowsky, MD, MPH
alexander.opotowsky@uphs.upenn.edu
Department of Medicine
University of Pennsylvania Medical Center
Philadelphia

Michael J. Landzberg, MD
Department of Medicine
Brigham and Women's Hospital
Boston, Massachusetts

Stephen E. Kimmel, MD, MSCE; Gary D. Webb, MD
Department of Medicine
University of Pennsylvania Medical Center
Philadelphia