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“双闭合”卵圆孔未闭：一例持续性偏头痛症状患者残余心房分流经皮治疗的病例报告

A 'twice closed' patent foramen ovale: a case report of percutaneous management of a residual interatrial shunt in a patient with persistent migraine symptoms.

作者信息

Rizza Vincenzo, Belli Martina, Stella Stefano, Montorfano Matteo, Agricola Eustachio

机构信息

IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy.

Unit of Cardiovascular Imaging, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.

出版信息

Eur Heart J Case Rep. 2024 Aug 26;8(9):ytae449. doi: 10.1093/ehjcr/ytae449. eCollection 2024 Sep.

DOI:10.1093/ehjcr/ytae449
PMID:39258019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11384891/
Abstract

BACKGROUND

Residual interatrial shunt following percutaneous patent foramen ovale (PFO) closure is a rare complication that can be associated with persistent migraine.

CASE SUMMARY

A 32-year-old woman with a history of percutaneous PFO closure due to a previous coronary paradoxical embolism and a condition of drug-refractory migraine underwent transoesophageal echocardiography (TOE) to investigate further recurrent migraine attacks. A partial displacement of a PFO occluder device was found, and it was successfully treated through the fluoroscopic and TOE-guided positioning of a second occluder in overlap with the previous one. The patient reported no more migraine attacks at the 6-month follow-up visit.

DISCUSSION

Residual interatrial shunt should be suspected in patients with persistent migraine and a history of percutaneous PFO closure. Fluoroscopic and TOE-guided closure of residual interatrial shunt with a second PFO occlude device seems to be a safe and clinically effective strategy to manage persistent migraine.

摘要

背景

经皮卵圆孔未闭（PFO）封堵术后残留房间隔分流是一种罕见的并发症，可能与持续性偏头痛有关。

病例摘要

一名32岁女性，既往因冠状动脉反常栓塞接受过经皮PFO封堵术，患有药物难治性偏头痛，接受经食管超声心动图（TOE）检查以进一步调查复发性偏头痛发作情况。发现PFO封堵器部分移位，通过在荧光透视和TOE引导下将第二个封堵器与前一个封堵器重叠定位成功进行了治疗。患者在6个月的随访中未再出现偏头痛发作。

讨论

对于患有持续性偏头痛且有经皮PFO封堵术病史的患者，应怀疑存在残留房间隔分流。使用第二个PFO封堵器在荧光透视和TOE引导下封堵残留房间隔分流似乎是治疗持续性偏头痛的一种安全且临床有效的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/d13e41bcbf7a/ytae449f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/e32420caf039/ytae449il2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/df8c8cbdff69/ytae449f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/496c1f2779b2/ytae449f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/24ac4f5c98d5/ytae449f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/ced18ce33eb0/ytae449f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/d13e41bcbf7a/ytae449f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/e32420caf039/ytae449il2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/df8c8cbdff69/ytae449f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/496c1f2779b2/ytae449f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/24ac4f5c98d5/ytae449f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/ced18ce33eb0/ytae449f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b827/11384891/d13e41bcbf7a/ytae449f5.jpg

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本文引用的文献

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EBioMedicine. 2024 Jan;99:104943. doi: 10.1016/j.ebiom.2023.104943. Epub 2023 Dec 23.
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The Correlation Between Migraine and Patent Foramen Ovale.偏头痛与卵圆孔未闭之间的相关性
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Effect of Residual Interatrial Shunt on Migraine Burden After Transcatheter Closure of Patent Foramen Ovale.房间隔缺损封堵术后残余房间隔分流对偏头痛负担的影响。
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