Mi Zeyu, Li Chao, He Gang, Huang Daxin, Zhou Xiangwei, Gao Hongli, Yang Deyu, Hu Yulin
Department of Cardiac Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
Departments of Cardiac Surgery, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Kunming, China.
Sci Rep. 2025 Jan 9;15(1):1497. doi: 10.1038/s41598-024-82122-2.
We aimed to evaluate the incidence of residual shunt after patent foramen ovale (PFO) closure and analyze the anatomical features of PFO to determine the risk factors for significant residual shunt after PFO closure. Ninety-two patients who underwent PFO closure at our center between September 2021 and June 2022 were consecutively enrolled. Transthoracic saline contrast echocardiography was performed at 6 and 12 months postoperatively to evaluate the presence of a significant residual shunt. Preoperative measurements of the anatomical structures of PFO were performed using transesophageal echocardiography. Binary logistic regression analysis was performed to determine the risk factors for significant residual shunt at 12 months after PFO closure, and receiving operating characteristic curves were plotted to calculate the cutoff values. At the follow-up 12 months postoperatively, 22 (24%) of the 92 patients showed significant residual shunt. Thicker secondary septum and longer tunnel were independent risk factors for significant residual shunt after PFO closure. In particular, patients with secondary septum thickness > 6.55 mm or tunnel length > 10.10 mm were more susceptible to significant residual shunt. This study may guide clinicians in developing individualized PFO treatment strategies.
我们旨在评估卵圆孔未闭（PFO）封堵术后残余分流的发生率，并分析PFO的解剖特征，以确定PFO封堵术后显著残余分流的危险因素。连续纳入了2021年9月至2022年6月期间在我们中心接受PFO封堵术的92例患者。术后6个月和12个月进行经胸盐水对比超声心动图检查，以评估是否存在显著残余分流。术前使用经食管超声心动图对PFO的解剖结构进行测量。进行二元逻辑回归分析以确定PFO封堵术后12个月时显著残余分流的危险因素，并绘制接受者操作特征曲线以计算临界值。术后12个月随访时，92例患者中有22例（24%）出现显著残余分流。继发隔增厚和隧道较长是PFO封堵术后显著残余分流的独立危险因素。特别是，继发隔厚度>6.55mm或隧道长度>10.10mm的患者更容易出现显著残余分流。本研究可能会指导临床医生制定个体化的PFO治疗策略。
