PDF(Pubmed)
Abstract：
UNASSIGNED: Percutaneous patent foramen ovale (PFO) closure is becoming more and more common for the treatment or prevention of PFO-associated right-to-left shunt (RLS). This study aims to investigate the value of transesophageal echocardiography (TEE) in percutaneous PFO closure, and to explore a new method that can improve intraoperative diagnosis and surgical safety.
UNASSIGNED: Based on our inclusion and exclusion criteria, we enrolled 73 patients between 16 and 70 years old (average age 43.25 ± 14.87 years) who underwent percutaneous PFO closure at the Department of Cardiac Surgery, Zhongshan Hospital (Xiamen), Fudan University, from January 2022 to December 2023. Out of the 73 enrolled patients, there were 28 males (38.36%) and 45 females (61.64%), 29 migraine patients (39.73%), 14 patients (19.19%) with headache and dizziness, 14 patients (19.18%) with a history of cerebral infarction (CI), and 25 patients (34.25%) with CI, lacunar infarction or ischemic focus on magnetic resonance imaging (MRI). All patients received routine transthoracic echocardiography (TTE) and agitated saline contrast echocardiography (ASCE) before operations. Percutaneous closure of PFO was completed under the guidance of TEE. In 12 patients, the method of \"injection of heparinized sterile saline through the delivery sheath\" was used to observe their RLS, and the anatomical characteristics of the PFO according to the shunt path were monitored and evaluated. This method was also applied to some patients to guide the conveyor to pass through the foramen ovale (FO) channel safely and effectively, thereby improving the success rate of PFO closure.
UNASSIGNED: The application of TEE during the procedure of percutaneous PFO closure, including preoperative evaluation, intraoperative guidance, and postoperative reevaluation, can offer further details about the anatomical and shunt characteristics of PFO, improve the diagnosis rate, and confirm the safety of the surgical path. It ensures the safety and reliability of the whole operation, greatly improving the success rate and reducing postoperative complications.
UNASSIGNED: TEE guidance of percutaneous PFO closure has the advantages of minimal trauma, no radiation and real-time visualization, while injecting heparinized sterile saline through the delivery sheath is safer and more effective in improving the success rate and reducing postoperative complications.
UNASSIGNED: Based on our inclusion and exclusion criteria, we enrolled 73 patients between 16 and 70 years old (average age 43.25 ± 14.87 years) who underwent percutaneous PFO closure at the Department of Cardiac Surgery, Zhongshan Hospital (Xiamen), Fudan University, from January 2022 to December 2023. Out of the 73 enrolled patients, there were 28 males (38.36%) and 45 females (61.64%), 29 migraine patients (39.73%), 14 patients (19.19%) with headache and dizziness, 14 patients (19.18%) with a history of cerebral infarction (CI), and 25 patients (34.25%) with CI, lacunar infarction or ischemic focus on magnetic resonance imaging (MRI). All patients received routine transthoracic echocardiography (TTE) and agitated saline contrast echocardiography (ASCE) before operations. Percutaneous closure of PFO was completed under the guidance of TEE. In 12 patients, the method of \"injection of heparinized sterile saline through the delivery sheath\" was used to observe their RLS, and the anatomical characteristics of the PFO according to the shunt path were monitored and evaluated. This method was also applied to some patients to guide the conveyor to pass through the foramen ovale (FO) channel safely and effectively, thereby improving the success rate of PFO closure.
UNASSIGNED: The application of TEE during the procedure of percutaneous PFO closure, including preoperative evaluation, intraoperative guidance, and postoperative reevaluation, can offer further details about the anatomical and shunt characteristics of PFO, improve the diagnosis rate, and confirm the safety of the surgical path. It ensures the safety and reliability of the whole operation, greatly improving the success rate and reducing postoperative complications.
UNASSIGNED: TEE guidance of percutaneous PFO closure has the advantages of minimal trauma, no radiation and real-time visualization, while injecting heparinized sterile saline through the delivery sheath is safer and more effective in improving the success rate and reducing postoperative complications.
摘要：
■经皮卵圆孔未闭（PFO）封堵术在治疗或预防PFO相关的左右分流（RLS）方面越来越普遍。本研究旨在探讨经食管超声心动图(TEE)在经皮PFO封堵术中的应用价值,并探索一种能提高术中诊断和手术安全性的新方法。
■根据我们的纳入和排除标准，我们纳入了73例16至70岁（平均年龄43.25±14.87岁）在心脏外科接受经皮PFO封堵的患者，中山医院(厦门),复旦大学,从2022年1月到2023年12月。在73名患者中，男性28人(38.36%),女性45人(61.64%),29例偏头痛患者（39.73%），14例(19.19%)头痛头晕,有脑梗死（CI）病史的患者14例（19.18%），25例（34.25％）有CI，腔隙性脑梗死或磁共振成像（MRI）的缺血性病灶。所有患者术前接受常规经胸超声心动图（TTE）和搅动盐水对比超声心动图（ASCE）。在TEE指导下经皮穿刺封堵PFO。在12名患者中，使用“通过递送鞘注射肝素化无菌盐水”的方法观察其RLS，根据分流路径对PFO的解剖特征进行了监测和评估。该方法还应用于一些患者，以引导输送机安全有效地通过卵圆孔（FO）通道，从而提高PFO闭合的成功率。
■经皮PFO封堵术中TEE的应用,包括术前评估，术中指导,术后重新评估，可以提供有关PFO的解剖和分流特性的更多详细信息，提高诊断率,并确认手术路径的安全性。保证了整个运行的安全性和可靠性，大大提高了成功率,减少了术后并发症。
■TEE指导经皮PFO闭合具有创伤小的优点，没有辐射和实时可视化，而通过给药鞘注射肝素化无菌生理盐水更安全，更有效地提高了成功率，减少了术后并发症。
■根据我们的纳入和排除标准，我们纳入了73例16至70岁（平均年龄43.25±14.87岁）在心脏外科接受经皮PFO封堵的患者，中山医院(厦门),复旦大学,从2022年1月到2023年12月。在73名患者中，男性28人(38.36%),女性45人(61.64%),29例偏头痛患者（39.73%），14例(19.19%)头痛头晕,有脑梗死（CI）病史的患者14例（19.18%），25例（34.25％）有CI，腔隙性脑梗死或磁共振成像（MRI）的缺血性病灶。所有患者术前接受常规经胸超声心动图（TTE）和搅动盐水对比超声心动图（ASCE）。在TEE指导下经皮穿刺封堵PFO。在12名患者中，使用“通过递送鞘注射肝素化无菌盐水”的方法观察其RLS，根据分流路径对PFO的解剖特征进行了监测和评估。该方法还应用于一些患者，以引导输送机安全有效地通过卵圆孔（FO）通道，从而提高PFO闭合的成功率。
■经皮PFO封堵术中TEE的应用,包括术前评估，术中指导,术后重新评估，可以提供有关PFO的解剖和分流特性的更多详细信息，提高诊断率,并确认手术路径的安全性。保证了整个运行的安全性和可靠性，大大提高了成功率,减少了术后并发症。
■TEE指导经皮PFO闭合具有创伤小的优点，没有辐射和实时可视化，而通过给药鞘注射肝素化无菌生理盐水更安全，更有效地提高了成功率，减少了术后并发症。
