SECTION I: BACKGROUND AND ANATOMY.- Historical perspective and importance of PFO.- Embryology, Neonatal Circulation and Anatomy of PFO.- Anatomical variations of Patent Foramen Ovale.- Aging and Patent Foramen Ovale.- SECTION II: METHODS AND TECHNIQUES FOR DETECTION AND CHARACTERIZATION OF PFO.- Echocardiographic detection and transcranial Doppler quantification of right-to-left shunting.- ICE: intra-procedural evaluation and guidance during closure of PFO.- A Comparison of Methods to Detect and Quantitative PFO: TCD, TTE, ICE and TEE.- Angiographic evaluation for PFO and Pulmonary AVMs.- SECTION III: PFO AND CLINICAL SYNDROMES.- An Overview of Clinical Syndromes (Keeping The Heart In Mind).- The Association of Patent Foramen Ovale and Migraine Headache.- Current Patient Management Issues, Clinical Trial Design Challenges and the Pathway Forward.- Patent foramen ovale and divers.- Orthodeoxia and Platypnea.- Obstructive Sleep Apnea and Patent Foramen Ovale.- PFO and Various Types of Surgery.- When a PFO is Discovered Incidentally.- SECTION IV: CLOSURE METHODS.- The GORE Septal Occluder.- The novel PFO specific closure devices: Why did they fail?.- Optimal device for children and closure indications in pediatric population.- Occlutech, PFM, Lifetech and other new devices. What's on the horizon?.- Complications of PFO Closure.- SECTION V: STATISTICAL METHODS, TRIALS AND TRIBULATIONS.- Device Closure of Patent Foramen Ovale or Medical Therapy for Cryptogenic Stroke: The CLOSURE I Trial.- The Gore REDUCE Clinical Study.- The PC Trial: An Effective Treatment Not Demonstrating Effective Power.- From FDAs point of view: What is needed to move PFO closure for stroke prevention forward?.- The Medical Device Manufacturer's Perspective - W.L. Gore & Associates, Inc.- PFO-Patient's Perspective.- Clinical Trials to Assess the Relationship between Patent Foramen Ovale and Migraine Headaches.- Do We Need More PFO Trials: Hypercoaguable Syndromes,Obstructive Sleep Apnea, and Arrhythmias.- SECTION VI: DIFFICULTIES/OBSTACLES IN STARTING PFO CLOSURE PRACTICE.- Obstacles in Starting a PFO Closure Program. How I Did It.- Developing a successful integrated PFO closure program.