Department of Medicine, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Catheter Cardiovasc Interv. 2009 Dec 1;74(7):1066-9. doi: 10.1002/ccd.22170.
The association between patent foramen ovale (PFO), atrial septal aneurysm, and cryptogenic stroke due to paradoxical embolism has been established. The correlation between atrial septal defect (ASD) in adults and paradoxical embolism is less well defined.
We examined our single center experience with 329 adult patients undergoing percutaneous device closure of interatrial communication defects to identify clinical and morphologic differences among adult patients with ASDs who presented with or without paradoxical embolism. Comparison was made with patients with PFO.
Although a significant left-to-right shunt was the predominant indication for ASD closure, 20 patients (14%) presented with a paradoxical embolism. These patients tended to be younger and had smaller defects (both by size and shunt ratio) than ASD patients without paradoxical embolism, and were more likely to be female than PFO patients.
The incidence of adult patients with ASD who presented with paradoxical embolism is higher than expected and suggests that this diagnosis should be considered in patients with cryptogenic stroke.
卵圆孔未闭（PFO）、房间隔瘤和由于反常栓塞引起的隐源性卒中之间存在关联已经确立。成人房间隔缺损（ASD）与反常栓塞之间的相关性尚未明确。
我们检查了我们单中心 329 例接受经皮装置闭合房间隔沟通缺陷的成年患者的经验，以确定有或没有反常栓塞的成年 ASD 患者之间的临床和形态学差异。并与 PFO 患者进行了比较。
尽管明显的左向右分流是 ASD 闭合的主要指征，但 20 例（14%）患者出现反常栓塞。这些患者的年龄较小，房间隔缺损（大小和分流比）较小，且女性患者多于 PFO 患者。
有反常栓塞表现的成年 ASD 患者的发病率高于预期，这表明对于隐源性卒中患者，应考虑这一诊断。
