Evaluation of the safety and efficacy of patent foramen ovale closure guided by transthoracic echocardiography

doi:10.11817/j.issn.1673-9248.2023.04.003

Abstract

Abstract:

Objective

To analyze the early safety and efficacy of patent foramen ovale (PFO) occlusion guided by transthoracic echocardiography (TTE).

Methods

The data of 403 patients who underwent TTE-guided PFO occlusion in our hospital from March 2019 to December 2022 were analyzed retrospectively, including 145 patients with stroke and 258 with migraine. We observed the severe surgical complications, the recurrence of stroke/TIA during perioperative period and 3 months after operation, and evaluated their safety; We compared the remission degree of migraine (headache impact test 6[HIT6], frequency and time of headache attack) by paired t-test before and 3 months after operation, and evaluated its effectiveness.

Results

403 cases of PFO occlusion were completed, and 20 patients stopped the operation because the sheath could not pass through, with a success rate of 95.04% (383/403). The average operation time was (23.3±7.3)min. In terms of severe surgical complications, there were 13 cases of pericardial effusion (3.23%, 13/403) and 4 cases of coronary gas embolism (0.99%, 4/403), and no complications such as the loss and displacement of occluder and peripheral vascular injury were found. 4 cases of coronary gas embolism improved after symptomatic treatment; Among 13 cases of pericardial effusion, 11 cases got better after pericardiocentesis and drainage, and 2 cases underwent emergency thoracotomy to stop bleeding. All cases were found to be left atrial appendage perforation during operation, and they were discharged after symptomatic treatment. All patients were followed up for 3 months after operation, and no complications such as occluder displacement, pericardial effusion and aortic valve insufficiency were found. No recurrence of stroke/TIA was found in stroke patients; Three months after operation, the average HIT6 score of migraine patients was (43.6±5.6), the average frequency of headache attack was (2.4±0.6) times/month, and the average attack time was (2.2±1.4) hours/time, which was significantly lower than that before operation [(43.6±5.6) scores vs (57.8±6.7) scores; (2.4±0.6) vs (6.4±2.3); (2.2±1.4) vs (7.4±4.5); t=25.45, 26.34, 17.27; all P＜0.001].

Conclusion

TTE-guided PFO occlusion is safe and effective.

Key words: Transthoracic echocardiography, Interventional therapy, Patent foramen ovale

Xinpeng Jiang, Xiaoming Li, Hang Yang, Yichen Gong, Yuanhao Fu, Yu Fu, Zhe Zhang. Evaluation of the safety and efficacy of patent foramen ovale closure guided by transthoracic echocardiography[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(04): 320-324.

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Figures/Tables 2

References 15

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