Presence of patent foramen ovale (PFO) has been associated with increased risk of cryptogenic stroke [1]. PFO is present in about 25% of the general adult population but is found in upto 40% of patients with cryptogenic stroke [1]. Three previously published randomized controlled trials (RCTs) did not demonstrate the superiority of transcatheter PFO closure over standard medical therapy (SMT) [2–4]. Recently, long-term outcomes of a previously negative RCT (RESPECT trial) and three other RCTs have shown a benefit of PFO closure in the terms of reduction in the recurrent strokes compared to SMT [5–8].