经导管介入封堵术治疗卵圆孔未闭的单中心回顾性分析

Single-center Retrospective Analysis of Transcatheter Interventional Closure for Patent Foramen Ovale

目的:分析经导管介入封堵治疗卵圆孔未闭的疗效及安全性。方法:2019年1月至2022年1月本院共收治卵圆孔未闭(patent foramen ovale,PFO)患者657例,分析PFO患者右向左分流(RLS)分布情况、RLS与PFO大小关系及介入手术并发症情况,比较手术成功率与PFO-RLS量相关性。结果:RLS筛查阳性人群中,少量RLS占55.6%,中量RLS占25.3%,大量RLS占19.1%。完成介入封堵术646例,排除未行经食管超声心动图(TEE)患者,88.9%的PFO直径<2 mm。PFO介入成功率与PFO-RLS量相关,RLS中大量分流介入成功率更高,与少量RLS间差异有统计学意义(P<0.001),中量与大量RLS间介入成功率差异无统计学意义(P>0.05);一站式冠脉介入诊疗或射频消融+PFO介入封堵临床可行。结论:经导管介入封堵治疗PFO安全有效,介入成功率与PFO-RLS量相关,一站式介入治疗安全有效,可常规开展。

Objective To analyze the efficacy and safety of transcatheter closure for patent foramen ovale.Methods From January 2019 to January 2022,657 patients with patent foramen ovale(PFO)were treated in our hospital.The distribution of right to left shunt(RLS)in PFO patients,the relationship between RLS and PFO size,and the complications of interventional surgery were analyzed.The correlation between the success rate of surgery and the amount of PFO-RLS was compared.Results Among the positive RLS screening population,a small amount of RLS accounted for 55.6%,a medium amount of RLS accounted for 25.3%,and a large amount of RLS accounted for 19.1%.Interventional occlusion was completed in 646 cases,excluding patients without TEE,and 88.9%of PFOs were<2 mm in diameter.The success rate of PFO was correlated with the amount of PFO-RLS.The success rate of large volume shunt intervention in RLS was higher than that of small volume RLS(P<0.001),and there was no significant difference between the success rate of moderate volume and large volume RLS(P>0.05);One-stop coronary intervention diagnosis and treatment or radiofrequency ablation+PFO intervention was clinically feasible.Conclusion Transcatheter interventional closure of PFO is safe and effective,and the success rate of intervention is related to the amount of PFO-RLS.One-stop interventional therapy is safe and effective and can be carried out routinely.