介入封堵术对卵圆孔未闭的疗效相关 进展
Progress in the Efficacy of Transcatheter Closure for Patent Foramen Ovale
DOI: 10.12677/acm.2026.1672492, PDF,   
作者: 喻厚登, 陈信光*:赣南医科大学第一附属医院心血管内科,江西 赣州
关键词: 卵圆孔未闭介入封堵术疗效并发症综述Patent Foramen Ovale Interventional Closure Efficacy Complications Review
摘要: 卵圆孔未闭是临床高发的先天性心脏病类型,其形成的心脏异常通道会改变正常血流动力学特征,长期可诱发多种并发症,严重降低患者生活质量,因此安全、有效的封堵干预成为临床研究重点。随着心脏介入诊疗技术的快速发展,介入封堵术凭借微创、高效等优势逐渐取代传统治疗方案,成为卵圆孔未闭的主流治疗手段。本文从卵圆孔未闭的诊断与分型、介入封堵器的研发进展、介入封堵术对相关并发症的治疗疗效及术后并发症等方面进行综述,旨在为临床优化卵圆孔未闭介入治疗方案、提升治疗安全性与有效性提供参考依据。
Abstract: Patent foramen ovale (PFO) is a common type of congenital heart disease in clinical practice. The abnormal cardiac channel formed by PFO alters the normal hemodynamic characteristics, which can induce a variety of complications in the long term and severely reduce patients’ quality of life. Therefore, safe and effective closure interventions have become the focus of clinical research. With the rapid development of cardiac interventional diagnosis and treatment technology, interventional closure has gradually replaced traditional treatment regimens due to its advantages of minimal invasiveness and high efficiency, and has become the mainstream treatment for PFO. This paper reviews the diagnosis and classification of PFO, the research progress of interventional occluders, the therapeutic efficacy of interventional closure on related complications, and postoperative complications, aiming to provide a reference for clinically optimizing the interventional treatment plan for PFO and improving the safety and effectiveness of treatment.
文章引用:喻厚登, 陈信光. 介入封堵术对卵圆孔未闭的疗效相关 进展[J]. 临床医学进展, 2026, 16(7): 10-17. https://doi.org/10.12677/acm.2026.1672492

参考文献

[1] 中华医学会心血管内科分会, 中国医师协会心血管内科分会. 卵圆孔未闭预防性封堵术中国专家共识[J]. 中国循环杂志, 2017, 32(3): 209-214.
[2] Alakbarzade, V., Keteepe-Arachi, T., Karsan, N., Ray, R. and Pereira, A.C. (2020) Patent Foramen Ovale. Practical Neurology, 20, 225-233. [Google Scholar] [CrossRef] [PubMed]
[3] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 卵圆孔未闭规范化诊疗中国专家共识[J]. 中华心血管病杂志, 2024, 52(4): 369-383.
[4] 经食道超声心动图临床应用的中国专家共识专家组. 卵圆孔未闭右心声学造影中国专家共识[J]. 中国循环杂志, 2022, 37(5): 449-458.
[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.
[6] Bridges, N.D., Hellenbrand, W., Latson, L., Filiano, J., Newburger, J.W. and Lock, J.E. (1992) Transcatheter Closure of Patent Foramen Ovale after Presumed Paradoxical Embolism. Circulation, 86, 1902-1908. [Google Scholar] [CrossRef] [PubMed]
[7] 周广泰, 周超, 张海军. 卵圆孔未闭封堵器材料研究进展[J]. 中国介入心脏病学杂志, 2024, 32(12): 709-716.
[8] Madhkour, R., Wahl, A., Praz, F. and Meier, B. (2019) Amplatzer Patent Foramen Ovale Occluder: Safety and Efficacy. Expert Review of Medical Devices, 16, 173-182. [Google Scholar] [CrossRef] [PubMed]
[9] Lin, C., Liu, L., Liu, Y. and Leng, J. (2021) Recent Developments in Next-Generation Occlusion Devices. Acta Biomaterialia, 128, 100-119. [Google Scholar] [CrossRef] [PubMed]
[10] 谢育梅, 陈军. 可降解封堵器治疗先天性心脏病的研究进展[J]. 中华实用儿科临床杂志, 2020, 35(1): 2-6.
[11] Li, Y., Chen, Z., Xie, Z., Wang, S., Xie, Y. and Zhang, Z. (2024) Recent Development of Biodegradable Occlusion Devices for Intra-Atrial Shunts. Reviews in Cardiovascular Medicine, 25, Article No. 159. [Google Scholar] [CrossRef] [PubMed]
[12] 李爱敏, 何建新, 张迎, 等. MemoSorb? 生物可降解封堵器卵圆孔未闭封堵术后近期疗效观察1例[J]. 中国介入心脏病学杂志, 2024, 32(3): 168-171.
[13] Murray, C.J.L. and Lopez, A.D. (2013) Measuring the Global Burden of Disease. New England Journal of Medicine, 369, 448-457. [Google Scholar] [CrossRef] [PubMed]
[14] Yaghi, S., Bernstein, R.A., Passman, R., Okin, P.M. and Furie, K.L. (2017) Cryptogenic Stroke. Circulation Research, 120, 527-540. [Google Scholar] [CrossRef] [PubMed]
[15] Hara, H., Virmani, R., Ladich, E., Mackey-Bojack, S., Titus, J., Reisman, M., et al. (2005) Patent Foramen Ovale: Current Pathology, Pathophysiology, and Clinical Status. Journal of the American College of Cardiology, 46, 1768-1776. [Google Scholar] [CrossRef] [PubMed]
[16] Lechat, P., Mas, J.L., Lascault, G., Loron, P., Theard, M., Klimczac, M., et al. (1988) Prevalence of Patent Foramen Ovale in Patients with Stroke. New England Journal of Medicine, 318, 1148-1152. [Google Scholar] [CrossRef] [PubMed]
[17] Webster, M.W.I., Smith, H.J., Sharpe, D.N., Chancellor, A.M., Swift, D.L., Bass, N.M., et al. (1988) Patent Foramen Ovale in Young Stroke Patients. The Lancet, 332, 11-12. [Google Scholar] [CrossRef] [PubMed]
[18] 陈步星, 付强, 王春雪. 卵圆孔未闭是否需要及时关闭? [J]. 中华心血管病杂志, 2018, 46(11): 846-848.
[19] Lee, P.H., Song, J., Kim, J.S., Heo, R., Lee, S., Kim, D., et al. (2018) Cryptogenic Stroke and High-Risk Patent Foramen Ovale: The DEFENSE-PFO Trial. Journal of the American College of Cardiology, 71, 2335-2342. [Google Scholar] [CrossRef] [PubMed]
[20] Mas, J.L., Derumeaux, G,. Guillon, B., et al. (2017) Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke. The New England Journal of Medicine, 377, 1011-1021.
[21] Søndergaard, L., Kasner, S.E., Rhodes, J.F., Andersen, G., Iversen, H.K., Nielsen-Kudsk, J.E., et al. (2017) Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke. New England Journal of Medicine, 377, 1033-1042. [Google Scholar] [CrossRef] [PubMed]
[22] Saver, J.L., Carroll, J.D., Thaler, D.E., Smalling, R.W., MacDonald, L.A., Marks, D.S., et al. (2017) Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke. New England Journal of Medicine, 377, 1022-1032. [Google Scholar] [CrossRef] [PubMed]
[23] 万林姗, 宋秀娟, 刘燕燕, 等. 偏头痛与卵圆孔未闭的研究进展[J]. 中国现代医学杂志, 2023, 33(10): 48-54.
[24] Del Sette, M., Angeli, S., Leandri, M., Ferriero, G., Bruzzone, G.L., Finocchi, C., et al. (1998) Migraine with Aura and Right-To-Left Shunt on Transcranial Doppler: A Case-Control Study. Cerebrovascular Diseases, 8, 327-330. [Google Scholar] [CrossRef] [PubMed]
[25] GBD 2016 Neurology Collaborators (2019) Global, Regional, and National Burden of Neurological Disorders, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18, 459-480.
[26] 乌云其达木改, 王云云, 马飞, 等. 偏头痛合并卵圆孔未闭病人介入封堵术的疗效及影响因素分析[J]. 临床外科杂志, 2022, 30(8): 758-761.
[27] Silalahi, T.D.A. and Hariyanto, T.I. (2024) Efficacy and Safety of Patent Foramen Ovale Closure for Mitigating Migraine: A Systematic Review and Meta-Analysis of Randomized Trials and Observational Studies. Therapeutic Advances in Neurological Disorders, 17. [Google Scholar] [CrossRef] [PubMed]
[28] Mattle, H.P., Evers, S., Hildick-Smith, D., Becker, W.J., Baumgartner, H., Chataway, J., et al. (2016) Percutaneous Closure of Patent Foramen Ovale in Migraine with Aura, a Randomized Controlled Trial. European Heart Journal, 37, 2029-2036. [Google Scholar] [CrossRef] [PubMed]
[29] Tobis, J.M., Charles, A., Silberstein, S.D., Sorensen, S., Maini, B., Horwitz, P.A., et al. (2017) Percutaneous Closure of Patent Foramen Ovale in Patients with Migraine: The PREMIUM Trial. Journal of the American College of Cardiology, 70, 2766-2774. [Google Scholar] [CrossRef] [PubMed]
[30] Lee, H., Lim, D.S., Lee, J., Lee, D., Oh, M., Park, J., et al. (2023) Decompression Illness in Divers with or without Patent Foramen Ovale: A Cohort Study. Annals of Internal Medicine, 176, 934-939. [Google Scholar] [CrossRef] [PubMed]
[31] Abdelfattah, O.M., Sayed, A., Elgendy, I.Y., Munir, M., Saleh, Y., Kapadia, S.R., et al. (2022) Patent Foramen Ovale Closure and Decompression Sickness among Divers. Cardiovascular Revascularization Medicine, 40, 160-162. [Google Scholar] [CrossRef] [PubMed]
[32] 刘瑶, 张丽娟, 雍永宏, 等. 斜卧呼吸-直立性低氧血症综合征机制与诊疗研究进展[J]. 心血管病学进展, 2023, 44(8): 752-756.
[33] Mojadidi, M.K., Gevorgyan, R., Noureddin, N. and Tobis, J.M. (2015) The Effect of Patent Foramen Ovale Closure in Patients with Platypnea‐Orthodeoxia Syndrome. Catheterization and Cardiovascular Interventions, 86, 701-707. [Google Scholar] [CrossRef] [PubMed]
[34] Pristipino, C., Germonpré, P., Toni, D., Sievert, H., Meier, B., D’Ascenzo, F., et al. (2021) European Position Paper on the Management of Patients with Patent Foramen Ovale. Part II—Decompression Sickness, Migraine, Arterial Deoxygenation Syndromes and Select High-Risk Clinical Conditions. EuroIntervention, 17, e367-e375. [Google Scholar] [CrossRef] [PubMed]
[35] Lee, J.J. and Sundar, K.M. (2021) Evaluation and Management of Adults with Obstructive Sleep Apnea Syndrome. Lung, 199, 87-101. [Google Scholar] [CrossRef] [PubMed]
[36] Guchlerner, M., Kardos, P., Liss-Koch, E., Franke, J., Wunderlich, N., Bertog, S., et al. (2012) PFO and Right-To-Left Shunting in Patients with Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine, 8, 375-380. [Google Scholar] [CrossRef] [PubMed]
[37] Li, X., Liu, C., Wu, J., Jia, Y., Li, H., Yu, H., et al. (2021) Analysis of the Characteristics of Sleep in Patients with Patent Foramen Ovale Complicated with Obstructive Sleep Apnea. Sleep and Breathing, 25, 1831-1836. [Google Scholar] [CrossRef] [PubMed]
[38] 孙永飞, 周彤, 罗勇, 等. 卵圆孔未闭与阻塞性睡眠呼吸暂停综合征共病增加反常性栓塞风险的研究进展[J]. 中国脑血管病杂志, 2022, 19(3): 205-210.
[39] 田润琦, 段鹏, 苏峰, 等. 介入封堵术有效改善阻塞性睡眠呼吸暂停综合征合并卵圆孔未闭患者近期预后[J]. 川北医学院学报, 2024, 39(7): 960-964.
[40] Heinisch, C., Bertog, S., Wunderlich, N., Majunke, N., Baranowski, A., Leetz, M., et al. (2012) Percutaneous Closure of the Patent Foramen Ovale Using the HELEX® Septal Occluder: Acute and Long-Term Results in 405 Patients. EuroIntervention, 8, 717-723. [Google Scholar] [CrossRef] [PubMed]
[41] Staubach, S., Steinberg, D.H., Zimmermann, W., Wawra, N., Wilson, N., Wunderlich, N., et al. (2009) New Onset Atrial Fibrillation after Patent Foramen Ovale Closure. Catheterization and Cardiovascular Interventions, 74, 889-895. [Google Scholar] [CrossRef] [PubMed]
[42] Guedeney, P., Laredo, M., Zeitouni, M., Hauguel-Moreau, M., Wallet, T., Elegamandji, B., et al. (2022) Supraventricular Arrhythmia Following Patent Foramen Ovale Percutaneous Closure. JACC: Cardiovascular Interventions, 15, 2315-2322. [Google Scholar] [CrossRef] [PubMed]
[43] Hauguel-Moreau, M., Guedeney, P., Dauphin, C., Auffret, V., Clerc, J., Marijon, E., et al. (2024) Flecainide to Prevent Atrial Arrhythmia after Patent Foramen Ovale Closure: AFLOAT Study, a Randomized Clinical Trial. Circulation, 150, 1659-1668. [Google Scholar] [CrossRef] [PubMed]
[44] 何璐, 张玉顺. 单中心1336例经导管封堵卵圆孔未闭患者主要并发症回顾性分析[J]. 中国介入心脏病学杂志, 2019, 27(6): 309-314.
[45] Hornung, M., Bertog, S.C., Franke, J., Id, D., Taaffe, M., Wunderlich, N., et al. (2013) Long-Term Results of a Randomized Trial Comparing Three Different Devices for Percutaneous Closure of a Patent Foramen Ovale. European Heart Journal, 34, 3362-3369. [Google Scholar] [CrossRef] [PubMed]