Giblett Joel P, Abdul-Samad Omar, Shapiro Leonard M, Rana Bushra S, Calvert Patrick A
Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust Cambridge, UK.
Division of Cardiovascular Medicine, University of Cambridge Cambridge, UK.
Interv Cardiol. 2019 Feb;14(1):34-41. doi: 10.15420/icr.2018.33.2.
Patent foramen ovale (PFO) is a common abnormality affecting between 20% and 34% of the adult population. For most people it is a benign finding; however, in some the PFO can open widely, enabling a paradoxical embolus to transit from the venous to arterial circulation, which is associated with stroke and systemic embolisation. Percutaneous closure of PFO in patients with cryptogenic stroke has been undertaken for a number of years, and a number of purpose-specific septal occluders have been marketed. Recent randomised controlled trials have demonstrated that closure of PFO in patients with cryptogenic stroke is associated with reduced rates of recurrent stroke. After a brief overview of the anatomy of a PFO, this review considers the evidence for PFO closure in cryptogenic stroke. The review also addresses other potential indications for closure, including systemic embolisation, decompression sickness, platypnoea-orthodeoxia syndrome and migraine with aura. It lays out the pre-procedural investigations and preparation for the procedure. Finally, it gives an overview of the procedure itself, including discussion of closure devices.
卵圆孔未闭（PFO）是一种常见的异常情况，影响着20%至34%的成年人群。对大多数人来说，这是一个良性发现；然而，在一些人中，PFO可能会广泛开放，使反常栓塞能够从静脉循环进入动脉循环，这与中风和全身栓塞有关。多年来一直在对不明原因卒中患者进行经皮PFO封堵术，并且已经有多种专用的房间隔封堵器上市。最近的随机对照试验表明，不明原因卒中患者的PFO封堵与复发性卒中发生率降低有关。在简要概述PFO的解剖结构后，本综述考虑了不明原因卒中患者PFO封堵的证据。该综述还讨论了封堵的其他潜在适应证，包括全身栓塞、减压病、平卧呼吸-直立性低氧血症综合征和伴有先兆的偏头痛。它阐述了术前检查和手术准备。最后，它概述了手术本身，包括对封堵装置的讨论。
