刘晓琴, 赵恩法, 谢航, 曾浩炜, 杜亚娟, 何璐, 张玉顺. 老年患者卵圆孔未闭多学科评估及封堵术后随访的单中心经验[J]. 心脏杂志, 2022, 34(3): 280-284. DOI: 10.12125/j.chj.202107085
    引用本文: 刘晓琴, 赵恩法, 谢航, 曾浩炜, 杜亚娟, 何璐, 张玉顺. 老年患者卵圆孔未闭多学科评估及封堵术后随访的单中心经验[J]. 心脏杂志, 2022, 34(3): 280-284. DOI: 10.12125/j.chj.202107085
    Xiao-qin LIU, En-fa ZHAO, Hang XIE, Hao-wei ZENG, Ya-juan DU, Lu HE, Yu-shun ZHANG. Single-center experience of multidisciplinary assessment of patent foramen ovale in elderly patients and follow-up after device closure[J]. Chinese Heart Journal, 2022, 34(3): 280-284. DOI: 10.12125/j.chj.202107085
    Citation: Xiao-qin LIU, En-fa ZHAO, Hang XIE, Hao-wei ZENG, Ya-juan DU, Lu HE, Yu-shun ZHANG. Single-center experience of multidisciplinary assessment of patent foramen ovale in elderly patients and follow-up after device closure[J]. Chinese Heart Journal, 2022, 34(3): 280-284. DOI: 10.12125/j.chj.202107085

    老年患者卵圆孔未闭多学科评估及封堵术后随访的单中心经验

    Single-center experience of multidisciplinary assessment of patent foramen ovale in elderly patients and follow-up after device closure

    • 摘要:
        目的  随机对照试验已经证实了经导管卵圆孔未闭 (PFO) 封堵在预防年轻PFO患者不明原因卒中的疗效。多项回顾性研究报道了老年人封堵术后复发性脑缺血事件的发生率较高。该研究基于多学科评估,探讨经导管 PFO 封堵术治疗老年高危PFO的安全性及疗效。
        方法  选择于西安交通大学第一附属医院结构性心脏病科住院诊断为不明原因栓塞性卒中或短暂性脑缺血发作(TIA)并最终接受 PFO 封堵术的60 岁以上高危PFO患者。所有患者术前均接受多学科评估以排除具有明确病因或其他可能因素导致的卒中/TIA,随访观察手术并发症及缺血事件发生情况。
        结果  共入选122例患者,平均年龄(64±5)岁,随访时间(2.5±1.7)年。共置入了两种封堵器,未发生严重不良事件,随访两种封堵器终点事件无差异。老年患者PFO封堵术后年复发性缺血性卒中/ TIA 的风险为0.67 %。
        结论  经多学科评估严格筛选后的高危老年PFO患者行封堵术是安全有效的,此类患者可以考虑接受经导管卵圆孔未闭封堵术,以预防脑血管事件复发。

       

      Abstract:
        AIM  To explore the safety and efficacy of transcatheter patent foramen ovale (PFO) occlusion in the treatment of high-risk PFO in the elderly patients on the basis of multidisciplinary evaluation.
        METHODS  Included in this study were the elderly patients admitted to our department from March 2014 to December 2020, who were diagnosed as having embolic strokes of undetermined source or transient ischemic attack (TIA) with high-risk PFO and received PFO closure. All the patients underwent multidisciplinary evaluation before the operation to rule out stroke/TIA that had a clear cause or other possible factors and after the operation the patients were followed up for complications and recurrent ischemic events.
        RESULTS  A total of 122 patients were enrolled (average age of 64(5)years) with mean follow-up time of 2.5±1.7 years. Two kinds of occluders were used in the study and there was no difference in the endpoint events between the two occluders and no serious adverse events occurred. The annual risk of recurrent ischemic stroke/TIA after PFO closure in elderly patients was 0.67%.
        CONCLUSION  It is safe and effective for high-risk elderly PFO patients to undergo transcatheter PFO closure after strict multidisciplinary evaluation. Such patients can be treated with percutaneous patent foramen ovale occlusion to prevent recurrence of cerebrovascular events.

       

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