Interventional Cardiology Unit, Ospedali Riuniti Padova Sud, Monselice, Padova, Italy.
Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
Eur J Intern Med. 2024 Feb;120:25-28. doi: 10.1016/j.ejim.2023.12.007. Epub 2023 Dec 10.
Atrial septal defects (ASD) and Patent foramen ovale (PFO) represent the most common congenital heart diseases (CHD) adulthood. These two clinical entities, having different embryological origin, as well as clinical manifestations, clinical course and treatment must be carefully distinguished. Right heart failure and pulmonary hypertension are considered the major determinants of morbidity and mortality in ASD. Conversely, new pathophysiology concepts have been raised in the management of PFO as left atrium cardiopathy. New diagnostic tools, including cardiac magnetic resonance and intracardiac echocardiography have joint transthoracic and transesophageal echocardiography in the diagnostic definition of both ASD and PFO as well as in guiding their percutaneous closure. Moreover, several innovations have been developed in the field of percutaneous ASD and PFO closure devices including new evidence supporting the safety and efficacy of device-based closure. Aim of the present review is to present review we provided and update overview on ASD and PFO, focusing on the novel concepts regarding their pathophysiological and therapeutic aspects.
房间隔缺损 (ASD) 和卵圆孔未闭 (PFO) 是成年人最常见的先天性心脏病 (CHD)。这两种临床实体具有不同的胚胎起源以及临床表现、临床病程和治疗方法,因此必须仔细区分。右心衰竭和肺动脉高压被认为是 ASD 发病率和死亡率的主要决定因素。相反,在 PFO 的治疗中提出了新的病理生理学概念,即左心房心脏病。新的诊断工具,包括心脏磁共振和心内超声,与经胸和经食管超声心动图联合使用,用于 ASD 和 PFO 的诊断定义以及指导其经皮闭合。此外,在经皮 ASD 和 PFO 闭合装置领域还开发了多项创新,包括支持基于器械闭合的安全性和有效性的新证据。本综述的目的是提供 ASD 和 PFO 的综述和最新概述,重点介绍其病理生理和治疗方面的新概念。