Björn Edvinsson1, Ulf Thilén1, Niels Erik Nielsen2, Christina Christersson3, Mikael Dellborg4, Peter Eriksson4, Joanna Hlebowicz1,5. 1. Department of Cardiology, Department of Clinical Science, Skåne University Hospital, Lund University, Lund, Sweden. 2. Department of Cardiology, Department of Clinical Science, University Hospital Linköping, Linköping University, Linköping, Sweden. 3. Department of Medical Sciences, Cardiology Uppsala University, Uppsala, Sweden. 4. Department of Cardiology, Department of Clinical Science, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. 5. Corresponding author: Dr Joanna Hlebowicz, Department of Cardiology, Skåne University Hospital, Lund University, SE-221, 85 Lund, Sweden, joanna.hlebowicz@med.lu.se.
Abstract
INTRODUCTION: Interatrial communication is associated with an increased risk of decompression sickness (DCS) in scuba diving. It has been proposed that there would be a decreased risk of DCS after closure of the interatrial communication, i.e., persistent (patent) foramen ovale (PFO). However, the clinical evidence supporting this is limited. METHODS: Medical records were reviewed to identify Swedish scuba divers with a history of DCS and catheter closure of an interatrial communication. Thereafter, phone interviews were conducted with questions regarding diving and DCS. All Swedish divers who had had catheter-based PFO-closure because of DCS were followed up, assessing post-closure diving habits and recurrent DCS. RESULTS: Nine divers, all with a PFO, were included. Eight were diving post-closure. These divers had performed 6,835 dives (median 410, range 140-2,200) before closure, and 4,708 dives (median 413, range 11-2,000) after closure. Seven cases with mild and 10 with serious DCS symptoms were reported before the PFO closure. One diver with a small residual shunt suffered serious DCS post-closure; however, that dive was performed with a provocative diving profile. CONCLUSION: Divers with PFO and DCS continue to dive after PFO closure and this seems to be fairly safe. Our study suggests a conservative diving profile when there is a residual shunt after PFO closure, to prevent recurrent DCS events. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
INTRODUCTION: Interatrial communication is associated with an increased risk of decompression sickness (DCS) in scuba diving. It has been proposed that there would be a decreased risk of DCS after closure of the interatrial communication, i.e., persistent (patent) foramen ovale (PFO). However, the clinical evidence supporting this is limited. METHODS: Medical records were reviewed to identify Swedish scuba divers with a history of DCS and catheter closure of an interatrial communication. Thereafter, phone interviews were conducted with questions regarding diving and DCS. All Swedish divers who had had catheter-based PFO-closure because of DCS were followed up, assessing post-closure diving habits and recurrent DCS. RESULTS: Nine divers, all with a PFO, were included. Eight were diving post-closure. These divers had performed 6,835 dives (median 410, range 140-2,200) before closure, and 4,708 dives (median 413, range 11-2,000) after closure. Seven cases with mild and 10 with serious DCS symptoms were reported before the PFO closure. One diver with a small residual shunt suffered serious DCS post-closure; however, that dive was performed with a provocative diving profile. CONCLUSION: Divers with PFO and DCS continue to dive after PFO closure and this seems to be fairly safe. Our study suggests a conservative diving profile when there is a residual shunt after PFO closure, to prevent recurrent DCS events. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Authors: Marko Ljubkovic; Zeljko Dujic; Andreas Møllerløkken; Darija Bakovic; Ante Obad; Toni Breskovic; Alf O Brubakk Journal: Med Sci Sports Exerc Date: 2011-06 Impact factor: 5.411
Authors: Michael Billinger; Rainer Zbinden; Raffaela Mordasini; Stephan Windecker; Markus Schwerzmann; Bernhard Meier; Christian Seiler Journal: Heart Date: 2011-09-13 Impact factor: 5.994
Authors: Andreas Møllerløkken; Toni Breskovic; Ivan Palada; Zoran Valic; Zeljko Dujic; Alf O Brubakk Journal: Diving Hyperb Med Date: 2011-09 Impact factor: 0.887
Authors: Jakub Honěk; Martin Šrámek; Tomáš Honěk; Aleš Tomek; Luděk Šefc; Jaroslav Januška; Jiří Fiedler; Martin Horváth; Štěpán Novotný; Josef Veselka Journal: J Am Coll Cardiol Date: 2020-09-01 Impact factor: 24.094
Authors: Simon J Mitchell; Michael H Bennett; Phillip Bryson; Frank K Butler; David J Doolette; James R Holm; Jacek Kot; Pierre Lafère Journal: Diving Hyperb Med Date: 2018-03-31 Impact factor: 0.887