D'Ascenzi Flavio, Minasi Vincenzo, Manfredi Guglielmo Leonardo, Ragazzoni Gian Luca, Cavigli Luna, Mandoli Giulia Elena, Pastore Maria Concetta, Focardi Marta, Cameli Matteo, Valente Serafina, Fineschi Massimo
Department of Medical Biotechnologies, Sports Cardiology and Rehab Unit, University of Siena, Siena, Italy.
Division of Cardiology, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy.
Scand J Med Sci Sports. 2025 Aug;35(8):e70116. doi: 10.1111/sms.70116.
Patent foramen ovale (PFO) and atrial septal defect (ASD) percutaneous closure is routinely performed. However, data on long-term safety and efficacy in athletes are lacking. This study with a long-term follow-up investigated the safety and efficacy of percutaneous PFO/ASD closure in athletes compared to non-athletes, focusing on the impact of sports participation on complications. The study included individuals < 50 years old undergoing percutaneous PFO/ASD closure. Athletes practiced sports for ≥ 4 h/week for ≥ 2 consecutive years before and after the procedure. Periprocedural complications, device dislocation, and bleeding events were assessed during a long-term follow-up (mean 10.6 ± 5.1 years). Echocardiography, including transcranial Doppler bubble test, was performed before discharge, at 1 and 3 months, and yearly thereafter. Seventy-six patients (36 athletes and 40 non-athletes) were included. Fourteen patients practiced sports at risk of trauma, and no differences in periprocedural complications were observed between the two groups. During the follow-up, no device dislocation was observed in athletes. A single major bleeding occurred in a non-athlete during dual antiplatelet therapy (DAPT). Eight minor bleedings occurred (4 during DAPT, 4 during single antiplatelet therapy-SAPT), with no significant difference between athletes and non-athletes (p = 0.23 and p = 0.79, respectively). One minor sports-related bleeding (muscular hematoma) occurred during SAPT in an athlete practicing kickboxing. Percutaneous PFO/ASD closure is safe in athletes, with no differences in complication rates between athletes and non-athletes observed during long-term follow-up (> 10 years). Sports participation did not significantly increase the bleeding risk, even in athletes practicing sports at risk of trauma.
卵圆孔未闭（PFO）和房间隔缺损（ASD）的经皮封堵术已常规开展。然而，关于运动员长期安全性和有效性的数据尚缺。这项长期随访研究调查了经皮PFO/ASD封堵术在运动员与非运动员中的安全性和有效性，重点关注运动参与对并发症的影响。该研究纳入了年龄<50岁且接受经皮PFO/ASD封堵术的个体。运动员在手术前后连续≥2年每周进行≥4小时的运动。在长期随访（平均10.6±5.1年）期间评估围手术期并发症、装置脱位和出血事件。出院前、术后1个月和3个月以及此后每年进行超声心动图检查，包括经颅多普勒气泡试验。共纳入76例患者（36例运动员和40例非运动员）。14例患者从事有创伤风险的运动，两组围手术期并发症无差异。随访期间，运动员未观察到装置脱位。1例非运动员在双联抗血小板治疗（DAPT）期间发生了1次严重出血。发生了8次轻微出血（DAPT期间4次，单联抗血小板治疗-SAPT期间4次），运动员和非运动员之间无显著差异（分别为p = 0.23和p = 0.79）。1例从事自由搏击运动的运动员在SAPT期间发生了1次轻微的与运动相关的出血（肌肉血肿）。经皮PFO/ASD封堵术在运动员中是安全的，在长期随访（>10年）期间，运动员和非运动员的并发症发生率无差异。即使是从事有创伤风险运动的运动员，运动参与也未显著增加出血风险。
