St Vincent's Hospital Sydney, Sydney, NSW.
Western Sydney University, Sydney, NSW.
Med J Aust. 2021 Jul;215(2):89-93. doi: 10.5694/mja2.51141. Epub 2021 Jul 4.
A patent foramen ovale (PFO) is an interatrial shunt, with a prevalence of 20-34% in the general population. While most people do not have secondary manifestations of a PFO, some reported sequelae include ischaemic stroke, migraine, platypnoea-orthodeoxia syndrome and decompression illness. Furthermore, in some cases, PFO closure should be considered for patients before neurosurgery and for patients with concomitant carcinoid syndrome. Recent trials support PFO closure for ischaemic stroke patients with high risk PFOs and absence of other identified stroke mechanisms. While PFOs can be associated with migraine with auras, with some patients reporting symptomatic improvement after closure, the evidence from randomised controlled trials is less clear in supporting the use of PFO closure for migraine treatment. PFO closure for other indications such as platypnoea-orthodeoxia syndrome, decompression illness and paradoxical embolism are based largely on case series with good clinical outcomes. PFO closure can be performed as a day surgical intervention with high procedural success and low risk of complications.
卵圆孔未闭（PFO）是一种房间隔分流，在普通人群中的患病率为 20-34%。虽然大多数人没有 PFO 的继发表现，但一些报道的后遗症包括缺血性脑卒中、偏头痛、低氧血症-直立性低氧血症综合征和减压病。此外，在某些情况下，PFO 闭合应在神经外科手术前考虑用于患者，以及伴有类癌综合征的患者。最近的试验支持对高危 PFO 且无其他确定的脑卒中机制的缺血性脑卒中患者进行 PFO 闭合。虽然 PFO 可与有先兆的偏头痛相关，一些患者报告闭合后症状改善，但随机对照试验的证据在支持 PFO 闭合治疗偏头痛方面并不明确。PFO 闭合治疗其他适应症，如低氧血症-直立性低氧血症综合征、减压病和反常栓塞，主要基于具有良好临床结局的病例系列。PFO 闭合可作为日间手术干预进行，具有较高的手术成功率和较低的并发症风险。
