Bacich Daniela, Fiorencis Andrea, Braggion Gabriele, Zuin Marco, Rigatelli Gianluca
Department of Cardiology, Madonna Della Salute Hospital, via Badaloni 25, Porto Viro, Rovigo, Italy.
Division of Cardiology, Adria General Hospital, Rovigo, Italy.
J Artif Organs. 2020 Jun;23(2):98-104. doi: 10.1007/s10047-019-01128-0. Epub 2019 Aug 28.
Left ventricular assist device (LVAD) implantation is an important treatment option for patients with advanced heart failure. The presence of a patent foramen ovale (PFO) may elicit undesired consequences in LVAD patients: hypoxemia and paradoxical embolization. The variable physiological status of the patient with heart failure can make pre-LVAD implant identification of a PFO elusive. When identified pre- or intraoperatively, PFO is closed at time of LVAD implantation. In the case of delayed diagnosis, percutaneous PFO closure has proven to be a feasible and safe solution. As mechanical circulatory support gains prevalence, it is important to raise awareness of physiological implications of right-to-left shunt during mechanical circulatory support. We reviewed the diagnostic and therapeutic management of PFO in LVAD patients.
左心室辅助装置（LVAD）植入是晚期心力衰竭患者的重要治疗选择。卵圆孔未闭（PFO）的存在可能在LVAD患者中引发不良后果：低氧血症和反常栓塞。心力衰竭患者的生理状态各异，这使得在LVAD植入前难以识别PFO。若在术前或术中识别出PFO，则在LVAD植入时将其闭合。对于延迟诊断的情况，经皮闭合PFO已被证明是一种可行且安全的解决方案。随着机械循环支持的普及，提高对机械循环支持期间右向左分流的生理影响的认识很重要。我们回顾了LVAD患者中PFO的诊断和治疗管理。
