Rana Bushra S, Shapiro Len M, McCarthy Karen P, Ho Siew Yen
Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK.
Eur J Echocardiogr. 2010 Dec;11(10):i19-25. doi: 10.1093/ejechocard/jeq122.
Patent foramen ovale (PFO) is known to occur with greater prevalence in those with cryptogenic stroke. These observations support the role of a PFO as a channel for paradoxical embolism and a mechanism for cerebral ischaemic events. Transcatheter closure of PFO may be indicated in this setting. A prerequisite of procedural success is achieving complete closure of the shunt. Studies have shown a varying degree of successful shunt closure. Residual shunts are usually the result of a mismatch between the device shape and PFO anatomy. In this article, we review the features of PFO and their surrounding structures as seen by three-dimensional transoesophageal echocardiography in patients undergoing transcatheter closure and relate these to the variations in morphology on anatomical specimens for a better appreciation of their suitability for closure devices. The salient features of the anatomical variations seen in adults undergoing transcatheter device closure have been summarized and used to produce a practical pre-procedural checklist.
已知卵圆孔未闭（PFO）在不明原因卒中患者中的发生率更高。这些观察结果支持PFO作为反常栓塞通道和脑缺血事件机制的作用。在这种情况下，可能需要行经导管封堵PFO。手术成功的一个先决条件是实现分流的完全封堵。研究表明，分流封堵的成功率各不相同。残余分流通常是由于装置形状与PFO解剖结构不匹配所致。在本文中，我们回顾了行经导管封堵的患者经三维经食管超声心动图观察到的PFO及其周围结构的特征，并将这些特征与解剖标本上的形态学变化相关联，以便更好地了解它们对封堵装置的适用性。对行经导管装置封堵的成人患者观察到的解剖学变异的显著特征进行了总结，并用于制定一份实用的术前检查表。
