Mirzada Naqibullah, Ladenvall Per, Hansson Per-Olof, Johansson Magnus Carl, Furenäs Eva, Eriksson Peter, Dellborg Mikael
GUCH Centre, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
Institute of Medicine, Dept. of Molecular and Clinical Medicine/Cardiology, The Sahlgrenska Academy at University of Gothenburg.
Int J Cardiol Heart Vessel. 2013 Nov 14;1:32-36. doi: 10.1016/j.ijchv.2013.11.003. eCollection 2013 Dec.
Observational studies favor percutaneous closure of patent foramen ovale (PFO) over medical treatment to reduce recurrent stroke while randomized trials fail to demonstrate significant superiority of percutaneous PFO closure. Few long-term studies are available post PFO closure. This study reports long-term clinical outcomes after percutaneous PFO closure.
Between 1997 and 2006, 86 consecutive eligible patients with cerebrovascular events, presumably related to PFO, underwent percutaneous PFO closure. All 86 patients were invited to a long-term follow-up, which was carried out during 2011 and 2012.
Percutaneous PFO closure was successfully performed in 85 of 86 patients. The follow-up rate was 100%. No cardiovascular or cerebrovascular deaths occurred. Two patients (both women) died from lung cancer during follow-up. Follow-up visits were conducted for 64 patients and the remaining 20 patients were followed up by phone. The mean follow-up time was 7.3 years (5 to 12.4 years). Mean age at PFO closure was 49 years. One patient had a minor stroke one month after PFO closure and a transient ischemic attack (TIA) two years afterwards. One other patient suffered from a TIA six years after closure. No long-term device-related complications were observed.
Percutaneous PFO closure was associated with very low risk of recurrent stroke and is suitable in most patients. We observed no mortality and no long-term device-related complications related to PFO closure, indicating that percutaneous PFO closure is a safe and efficient treatment even in the long term.
观察性研究表明，经皮闭合卵圆孔未闭（PFO）在减少复发性卒中方面优于药物治疗，而随机试验未能证明经皮PFO闭合具有显著优越性。PFO闭合后的长期研究较少。本研究报告经皮PFO闭合后的长期临床结果。
1997年至2006年期间，86例连续符合条件的脑血管事件患者（推测与PFO有关）接受了经皮PFO闭合术。所有86例患者均被邀请进行长期随访，随访于2011年至2012年进行。
86例患者中有85例成功进行了经皮PFO闭合术。随访率为100%。未发生心血管或脑血管死亡。2例患者（均为女性）在随访期间死于肺癌。对64例患者进行了随访，其余20例患者通过电话随访。平均随访时间为7.3年（5至12.4年）。PFO闭合时的平均年龄为49岁。1例患者在PFO闭合后1个月发生轻度卒中，2年后发生短暂性脑缺血发作（TIA）。另1例患者在闭合后6年发生TIA。未观察到长期的器械相关并发症。
经皮PFO闭合术复发性卒中风险极低，适用于大多数患者。我们观察到与PFO闭合相关的无死亡率和无长期器械相关并发症，表明经皮PFO闭合术即使在长期也是一种安全有效的治疗方法。
