Percutaneous Closure of Patent Foramen Ovale under TEE
Guidance in Cryptogenic Stroke and Migraine
Chaozhong Long, Yaoguang
Feng*, Xiaolin Lyv, Zhengwen Lei,
Zusong Tan, Wenan Kuang, and Hao Deng
The
First Affiliated Hospital, Department of Cardiovascular Surgery,
Hengyang Medical School, University of South China, Hengyang, Hunan,
421001, China
* Corresponding author: Feng Yao-guang, Email:fengyaog@hotmail.com
Abstract:
Background . To investigate safety and clinical efficacy of
percutaneous closure of PFO under TEE guidance in patients with
cryptogenic stroke (CS) and migraine, combined PFO and large
right-to-left shunt(RLS).
Methods . From January 2018 to June 2021 in our hospital, 128
patients were treated by percutaneous PFO occlusion under TEE guidance
in CS and migraine. Effective occlusion rate, complications, cerebral
ischemia events, migraine relief, and hospitalization costs were
analyzed. Postoperative follow-up were conducted.
Results. All the 128 patients were successful in percutaneous
PFO occlusion. The average operation time was 20~32
(25.6±4.2) min, the average hospitalization time was
2~3(2.8±0.4) d. There were 122 patients without RLS and
6 patients with medium residual RLS, with the sealing efficiency of
95.31% by TTE and right heart contrast echocardiography. 30 patients
with migraine underwent percutaneous PFO occlusion, 24 patients relief
after operation, with a relief rate of 80.0%. Postoperative follow-up
was conducted for 1-36(28.8±3.6)months, and no follow-up was lost. 98
cases of CS with PFO underwent percutaneous blockade were followed up
without cerebral embolism recurrence, 26 of 30 patients with migraine
received significant remission of migraine, with remission rate of
86.66%. There were no serious adverse events.
Conclusions. For patients with CS and migraine, combined PFO
and large RLS, percutaneous PFO occlusion under the guidance of TEE has
fewer complications and is safe and effective. It can prevent the
recurrence of CS and treat migraine..