PDF(Pubmed)
Abstract：
UNASSIGNED: Suture-mediated patent fossa ovalis (PFO) closure is a recent technique, achieving closure by means of a simple suture. The differences between traditional occluders and suture might have different impacts on atrial function. The aim of this study was to evaluate atrial function after PFO closure by direct suture and traditional occluders.
UNASSIGNED: We prospectively studied 40 patients, 20 undergoing PFO closure by occluder and 20 by suture. Trans-thoracic echocardiography was carried out the day before and 1 year after the procedure. Left atrial (LA) and right atrial (RA) function was evaluated by using speckle-tracking analysis assessing the strain values of the reservoir (st-RES), conduit (st-CD), and contraction phase (st-CT). Compared with values baseline PFO closure, at 1-year follow-up, patients with occluder implantation had significantly worse indices of LA and RA reservoir (LA st-RES P < 0.001; RA st-RES P < 0.001), conduit (LA st-CD P < 0.001; RA st-CD P < 0.001), and contraction function (LA st-CT P < 0.05; RA st-CT P < 0.05). In patients with suture-mediated PFO closure, no significant differences were observed in the same indices of reservoir (LA st-RES P = 0.848; RA st-RES P = 0.183), conduit (LA st-CD P = 0.156; RA st-CD P = 0.419), and contraction function (LA st-CT P = 0.193; RA st-CT P = 0.375).
UNASSIGNED: Suture-mediated PFO closure does not alter atrial function. Conversely, PFO closure by metallic occluders is associated with a deterioration of atrial function. This detrimental effect on atrial function could favour the development of atrial arrhythmias.
UNASSIGNED: We prospectively studied 40 patients, 20 undergoing PFO closure by occluder and 20 by suture. Trans-thoracic echocardiography was carried out the day before and 1 year after the procedure. Left atrial (LA) and right atrial (RA) function was evaluated by using speckle-tracking analysis assessing the strain values of the reservoir (st-RES), conduit (st-CD), and contraction phase (st-CT). Compared with values baseline PFO closure, at 1-year follow-up, patients with occluder implantation had significantly worse indices of LA and RA reservoir (LA st-RES P < 0.001; RA st-RES P < 0.001), conduit (LA st-CD P < 0.001; RA st-CD P < 0.001), and contraction function (LA st-CT P < 0.05; RA st-CT P < 0.05). In patients with suture-mediated PFO closure, no significant differences were observed in the same indices of reservoir (LA st-RES P = 0.848; RA st-RES P = 0.183), conduit (LA st-CD P = 0.156; RA st-CD P = 0.419), and contraction function (LA st-CT P = 0.193; RA st-CT P = 0.375).
UNASSIGNED: Suture-mediated PFO closure does not alter atrial function. Conversely, PFO closure by metallic occluders is associated with a deterioration of atrial function. This detrimental effect on atrial function could favour the development of atrial arrhythmias.
摘要：
■缝合介导的卵圆窝（PFO）闭合是一种最新技术，通过简单的缝合线实现闭合。传统封堵器和缝合器之间的差异可能对心房功能产生不同的影响。这项研究的目的是通过直接缝合和传统封堵器评估PFO闭合后的心房功能。
■我们前瞻性研究了40例患者，20通过封堵器进行PFO闭合，20通过缝线进行PFO闭合。在手术前一天和手术后1年进行经胸超声心动图检查。左心房(LA)和右心房(RA)功能通过散斑追踪分析评估储层(st-RES)的应变值,导管（st-CD），和收缩阶段（ST-CT）。与基准PFO闭合值相比，在1年的随访中，封堵器植入患者的LA和RA储层指数明显较差（LAst-RESP<0.001；RAst-RESP<0.001），导管(LAst-CDP<0.001；RAst-CDP<0.001)，和收缩功能（LAst-CTP<0.05；RAst-CTP<0.05）。在缝合介导的PFO闭合患者中，在相同的储层指数中没有观察到显着差异（LAst-RESP=0.848；RAst-RESP=0.183），导管(LAst-CDP=0.156；RAst-CDP=0.419)，和收缩功能（LAst-CTP=0.193；RAst-CTP=0.375）。
■缝合介导的PFO闭合不改变心房功能。相反，通过金属封堵器关闭PFO与心房功能的恶化有关。这种对心房功能的不利影响可能会促进房性心律失常的发展。
■我们前瞻性研究了40例患者，20通过封堵器进行PFO闭合，20通过缝线进行PFO闭合。在手术前一天和手术后1年进行经胸超声心动图检查。左心房(LA)和右心房(RA)功能通过散斑追踪分析评估储层(st-RES)的应变值,导管（st-CD），和收缩阶段（ST-CT）。与基准PFO闭合值相比，在1年的随访中，封堵器植入患者的LA和RA储层指数明显较差（LAst-RESP<0.001；RAst-RESP<0.001），导管(LAst-CDP<0.001；RAst-CDP<0.001)，和收缩功能（LAst-CTP<0.05；RAst-CTP<0.05）。在缝合介导的PFO闭合患者中，在相同的储层指数中没有观察到显着差异（LAst-RESP=0.848；RAst-RESP=0.183），导管(LAst-CDP=0.156；RAst-CDP=0.419)，和收缩功能（LAst-CTP=0.193；RAst-CTP=0.375）。
■缝合介导的PFO闭合不改变心房功能。相反，通过金属封堵器关闭PFO与心房功能的恶化有关。这种对心房功能的不利影响可能会促进房性心律失常的发展。
