Pristipino Christian
U.O.C. Emodinamica, P.O. San Filippo Neri, ASL Roma 1, Roma.
G Ital Cardiol (Rome). 2019 Mar;20(3 Suppl 1):4S-8S. doi: 10.1714/3121.31035.
Patent foramen ovale (PFO) is associated with a number of clinical syndromes in which it plays variable roles that, often, cannot be accurately determined. This situation creates conflicting data and controversial studies. However, in 2017 and 2018, four randomized clinical trials have been published, allowing for the clarification of certain issues pertaining to cryptogenic stroke. Shortly after this, 8 European scientific societies collaborated to publish the first official international position paper on PFO and cryptogenic stroke, based upon best-available evidence. In the current report, the main positions are presented, relating to PFO diagnosis, general management, and therapeutic choices. Generally speaking, given the complexity of PFO roles, an interdisciplinary and personalized approach was chosen, especially taking into consideration patient involvement at all stages of management. This approach is not suitably addressed by standard guidelines, but can be accommodated in a position statement like this. For this reason, it was possible to offer an approach capable of aiding clinicians to make rational, patient-shared decisions, even when the available evidence is either weak or scarce.
卵圆孔未闭（PFO）与多种临床综合征相关，在这些综合征中它发挥着不同的作用，而这些作用往往无法准确确定。这种情况导致了相互矛盾的数据和有争议的研究。然而，在2017年和2018年，四项随机临床试验得以发表，这有助于澄清一些与不明原因卒中相关的问题。此后不久，8个欧洲科学学会合作，基于现有最佳证据，发表了首份关于PFO与不明原因卒中的官方国际立场文件。在本报告中，阐述了有关PFO诊断、一般管理和治疗选择的主要立场。一般而言，鉴于PFO作用的复杂性，选择了一种跨学科的个性化方法，尤其考虑到患者在管理的各个阶段的参与。这种方法无法通过标准指南得到妥善解决，但可以在这样的立场声明中得到体现。因此，即便现有证据薄弱或稀少，也能够提供一种有助于临床医生做出合理的、患者共同参与的决策的方法。
