Patent foramen ovale, or closure of the “hole in the heart,” is effective, has a low incidence of complications, and is well tolerated, according to a narrative review released today. Australian Medical Journal..
Patent foramen ovale (PFO) is formed in the foetation and is an important pathway for blood circulation from the right atrium to the left atrium of the heart before the lungs are fully functional. At birth, the blood returning from the pulmonary circulation increases with lung function and closes the PFO. However, closures do not occur in 20-34% of the general population. In most cases, PFO does not cause problems, but complications can occur.
The authors, led by Dr. David Roy and Dr. Kenneth Cho of St Vincent’s Hospital Sydney, conducted a literature review for studies investigating the indications, approaches, and complications of PFO closure.
The results of their survey are as follows.
- Most people do not have secondary symptoms of PFO, but reported sequelae include ischemic stroke, migraine, platypnea-orthodeoxya syndrome, and decompression sickness. In addition, in some cases, PFO closure should be considered for patients before neurosurgery and for patients with carcinoid syndrome.
- Recent trials support PFO closure Ischemic stroke Patients with high-risk PFO and no other identified stroke mechanism.
- PFO may be associated with migraine with aura, and some patients have reported improvement in symptoms after closure, but randomized controlled trials supporting the use of PFO closure for the treatment of migraine The evidence from the trial is not very clear.
- PFO closure for other indications such as Platypnoea-Orthodeoxia syndrome, decompression sickness, and paradoxical embolism is primarily based on a series of cases with good clinical outcomes.
- PFO closure can be done as one day Surgical intervention The success rate of the procedure is high and the risk of complications is low.
“PFO closure is a safe and effective procedure, and the success rate of closure is very high and low. complications “Rate,” Roy and his colleagues conclude.
“Further research is needed to identify subgroups that may further benefit from PFO closure.”
Kenneth K Cho et al, Permanent Pathology of Patent foramen ovale: Literature Review, Australian Medical Journal (2021). DOI: 10.5694 / mja2.51141
Provided by the Australian Medical Journal (MJA)
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The procedure to puncture the heart is effective and safe
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