Ghiglia S, Fesslovà V
Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli Regina Elena, Milano.
Pediatr Med Chir. 2008 Jul-Aug;30(4):192-6.
The aim of our study was evaluate the clinical outcome of PFO without associated congenital heart disease, in the 1st year of life, in a consecutive series of preterm vs term infants. Out of 178 infants, 83 F/94 M, 49% born preterm, with echo diagnosis of PFO (< 5 mm) by 1 month of age, 122 were controlled at 3 mo, 67 at 6 mo and 30 at 12 mo distance. 23 (12%) had an associated PDA, 11 preterm (6 G.A. <32 w). Closure at f-u GA > 38 > 32 < 38 < 32 3mo 38/122 31% 24/66 35% 11/42 26% 3/14 22% 6mo 38/67 57% 20/35 57% 13/25 52% 5/7 71% 12 m 11/30 37% 5/13 38% 5/15 33% 1/2 50% PFO diameter slightly increased in 2 out of 122 (ga. > 38 w), remained so in 6, and decreased in 108. Only 3/33 children whose PFO was closed at 3rd month control were. <32 wGA. No one was hemodynamically significant. In all right ventricular prevalence both at ECG and Echo normalized by 3 mo of age: 21/23 PDA spontaneously closed by the following control before PFO closure. Our data show that: (1) PFO has no clinical relevance even in the WLGA newborn; (2) Inverse correlation between GA and early closure; (3) PDA was'nt predictive for early closure; (4) Spontaneous closure of ductus was always earlier the the FOP's one. Our data support that even in preterm infants PFO is benign and there is no need for an emotionally expensive and time losing follow-up.
我们研究的目的是评估在生命的第一年,一系列连续的早产儿与足月儿中,无相关先天性心脏病的卵圆孔未闭(PFO)的临床结局。在178名婴儿中,83名女性/94名男性,49%为早产儿,在1月龄时经超声心动图诊断为PFO(<5mm),122名在3个月时接受检查,67名在6个月时接受检查,30名在12个月时接受检查。23名(12%)伴有动脉导管未闭(PDA),11名早产儿(6名胎龄<32周)。随访时胎龄>38周>32周<38周<32周 3个月 38/122 31% 24/66 35% 11/42 26% 3/14 22% 6个月 38/67 57% 20/35 57% 13/25 52% 5/7 71% 12个月 11/30 37% 5/13 38% 5/15 33% 1/2 50% 122名(胎龄>38周)中有2名PFO直径略有增加,6名保持不变,108名减小。在3个月检查时PFO闭合的33名儿童中只有3名胎龄<32周。无一例具有血流动力学意义。在所有病例中,右心室患病率在心电图和超声心动图检查中在3月龄时均恢复正常:21/23例PDA在PFO闭合前的下一次检查时自发闭合。我们的数据表明:(1)即使在小于胎龄儿(WLGA)新生儿中,PFO也无临床相关性;(2)胎龄与早期闭合呈负相关;(3)PDA不能预测早期闭合;(4)动脉导管的自发闭合总是早于PFO的闭合。我们的数据支持即使在早产儿中PFO也是良性的,无需进行耗费精力和时间的随访。