应用ADOⅡ封堵器经皮介入治疗低位卵圆孔未闭1例Percutaneous closure of patent foramen ovale in a low-level position using Amplatzer ADOⅡ occluder: a case report
胡海波,黄浩佳,栗政伟,吕建华,潘湘斌
摘要(Abstract):
低位卵圆孔未闭(PFO)是指PFO封堵术中PFO开口位置偏低,其左心房面开口距离二尖瓣房间隔侧根部距离小于9 mm的一种少见类型PFO。对于低位PFO目前临床上常用的双盘式PFO封堵器其最小型号(18 mm/18 mm)放置后封堵器边缘也会触碰到二尖瓣,导致二尖瓣反流或瓣叶磨蚀风险增加,一般术中遇到此情况只能放弃封堵。本病例报道采用Amplatzer ADOⅡ封堵器介入封堵低位PFO的成功病例,为这种少见类型PFO的介入封堵提供了新的思路和策略。
关键词(KeyWords): 卵圆孔未闭;二尖瓣反流;介入封堵
基金项目(Foundation): 中央高水平医院临床科研业务费项目(2022-GSP-GG-18)
作者(Author): 胡海波,黄浩佳,栗政伟,吕建华,潘湘斌
参考文献(References):
- [1] S?ndergaard L,Kasner SE,Rhodes JF,et al. Patent foramen ovale closure or antiplatelet therapy for cryptogenic stroke[J]. N Engl J Med,2017,377(11):1033-1042. DOI:10.1056/NEJMoa1707404.
- [2] Mas JL,Derumeaux G,Guillon B,et al. Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke[J].N Engl J Med,2017,377(11):1011-1021. DOI:10.1056/NEJMoa1705915.
- [3] Saver JL,Carroll JD,Thaler DE,et al. Long-term outcomes of patent foramen ovale closure or medical therapy after stroke[J].N Engl J Med,2017,377(11):1022-1032. DOI:10.1056/NEJMoa1610057.
- [4] Lee PH,Song JK,Kim JS,et al. Cryptogenic stroke and highrisk patent foramen ovale:the DEFENSE-PFO trial[J]. J Am Coll Cardiol,2018,71(20):2335-2342. DOI:10.1016/j.jacc.2018.02.046.
- [5]张玉顺,蒋世良,朱鲜阳.卵圆孔未闭相关卒中预防中国专家指南[J].心脏杂志,2021,33(1):1-10. DOI:10.12125/j.chj.202101022.
- [6] Kuijpers T,Spencer FA,Siemieniuk RAC,et al. Patent foramen ovale closure,antiplatelet therapy or anticoagulation therapy alone for management of cryptogenic stroke? A clinical practice guideline[J]. BMJ,2018,362:k2515.DOI:10.1136/bmj.k2515.
- [7] MesséSR,Gronseth GS,Kent DM,et al. Practice advisory update summary:patent foramen ovale and secondary stroke prevention:report of the Guideline Subcommittee of the American Academy of Neurology[J]. Neurology,2020,94(20):876-885. DOI:10.1212/WNL.0000000000009443.
- [8] Pristipino C,GermonpréP,Toni D,et al. European position paper on the management of patients with patent foramen ovale.PartⅡ-Decompression sickness,migraine,arterial deoxygenation syndromes and select high-risk clinical conditions[J]. Eur Heart J,2021,42(16):1545-1553. DOI:10.1093/eurheartj/ehaa1070.
- [9] Stortecky S,da Costa BR,Mattle HP,et al. Percutaneous closure of patent foramen ovale in patients with cryptogenic embolism:a network meta-analysis[J]. Eur Heart J,2015,36(2):120-128. DOI:10.1093/eurheartj/ehu292.
- [10] Sigusch HH,Zimmermann B,Kuntze T,et al. Cardiac tamponade following aortic root erosion by an Amplatzer PFOOccluder in a 41-year-old woman:only a matter of sizing?[J].J Cardiol Cases,2020,23(3):123-126. DOI:10.1016/j.jccase.2020.10.014.
- [11] Amin Z,Hijazi ZM,Bass J,et al. PFO closure complications from the AGA registry[J]. Catheter Cardiovasc Interv,2008,72(1):74-79. DOI:10.1002/ccd.21582.
- [12] Kibler M,Marzak H,Jesel L,et al. High-grade atrioventricular block occurring during percutaneous closure of patent foramen ovale:a case report[J]. Eur Heart J Case Rep,2020,4(4):1-5. DOI:10.1093/ehjcr/ytaa141.
- [13] Krasniqi N,Roth J,Siegrist PT,et al. Percutaneous closure of patent foramen ovale and valvular function--effect of the amplatzer occluder[J]. J Invasive Cardiol,2012,24(6):274-277.
- [14] W?hrle J,Kochs M,Spiess J,et al. Impact of percutaneous device implantation for closure of patent foramen ovale on valve insufficiencies[J]. Circulation,2009,119(23):3002-3008. DOI:10.1161/CIRCULATIONAHA.109.851014.
- [15]黄浩佳,胡海波.应用ADOⅡ封堵器经皮介入治疗卵圆孔未闭封堵术后残余分流1例[J].中国介入心脏病学杂志,2022,30(9):709-710. DOI:10.3969/j.issn.1004-8812.2022.09.014.
- [16]张辉,胡海波,吕建华,等.经肱动脉入路介入治疗外科瓣膜置换术后瓣周漏[J].中华心血管病杂志,2021,49(5):467-473. DOI:10.3760/cma.j.cn112148-20210329-00278.
- [17] Cen H,Peng B,Li J,et al. Efficacy and safety of the Amplatzer Duct Occluder II for ventricular septal defect closure:a meta-analysis[J]. Kardiol Pol,2021,79(4):401-409.DOI:10.33963/KP.15762.