Patent Foramen Ovale Not So Patent

Transesophageal echocardiography (TEE) with agitated saline contrast is the most sensitive tool for diagnosing patent foramen ovale (PFO), but false positives can result. We report a patient who underwent a TEE during the study of a cryptogenic stroke. Contrast appeared in the left atrium with the Valsalva maneuver. However, the contrast exit site was not identified, and contrast continued to appear with Valsalva once the saline microbubbles had disappeared. Combined with the contrast characteristics, this suggested a spontaneous contrast phenomenon rather than a PFO. This phenomenon must be kept in mind to avoid overdiagnosing PFO .     

卵圆孔未闭与缺血性卒中

尽管采取了详细的检查,但仍有约1/3的缺血性卒中病因尚不明确,称为原因不明性缺血性卒中.近20年来,人们发现卵圆孔未闭(PFO)与这些原因不明性卒中关系密切,并随之进行了大量深入的研究,提出许多新的观念.文章就PFO与缺血性卒中的关系、PFO引起缺血性卒中的影响因素以及PFO诊断和治疗方面的研究进展进行了综述.     

矛盾性栓塞与卵园孔未闭

矛盾性栓塞 (ｐａｒａｄｏｘｉｃａｌｅｍｂｏｌｉｓｍ)是指静脉系统和右心房的血栓通过心脏内的交通从右心系统进入左心系统 ,引起心、脑、肾以及外周血管的动脉栓塞。其发生需要三个前提 :(1)静脉和右心系统有血栓 ;(2 )存在右向左的分流 ;(3)栓子栓塞了动脉循环。矛盾性栓塞的病人常有室间隔缺损、房间隔缺损、动脉导管未闭或者肺动静脉畸形等动静脉交通存在。但是最常见的动静脉交通是卵圆孔未闭。卵圆孔未闭 (ｐａｔｅｎｔｆｏｒａｍｅｎｏｖａｌｅ ,ＰＦＯ)是指在卵圆孔位置的心房原发隔与继发隔之间的裂隙样开口。在胎儿期卵圆孔作为…     

Multiple Intracardiac and Paradoxical Thrombi Caused by a Thrombus Entrapped in a Patent Foramen Ovale

Patent foramen ovale (PFO) usually represents a benign incidental finding. Occasionally, a PFO can open widely, resulting in paradoxical embolism, with potentially devastating consequence. Floating intracardiac thrombi and thrombus straddling a PFO are 2 extremely rare conditions associated with a dismal prognosis and encountered almost exclusively in the setting of pulmonary embolism (PE). We report the unusual case of a 47-year-old man with an unremarkable medical history who presented with a bilateral PE and multiple paradoxical and intracardiac floating thrombi in the setting of a thrombus entrapped in a PFO.     

卵圆孔未闭的研究进展

一直以来认为卵圆孔未闭对心脏的血流动力学无影响,因而不被重视,然而,近年来的研究发现卵圆孔未闭与不明原因的脑栓塞、减压病、偏头痛等的发病有关,闭合未闭的卵圆孔可能对其有益处,现就此做一综述。