"One-stop"Surgery for Patients with Patent Foramen Ovale and Coronary Heart Disease:A Single-center Retrospective Analysis

Yuan Ping; Xiong Zijun; Shen Jun; Wang Jianing; Liu Wenting

doi:10.3969/j.issn.1674-4055.2023.12.05

Abstract：Objective The follow-up showed that there was no significant increase in events such as bleeding,stroke,residual shunt from the occluder,thrombosis,and myocardial infarction in both groups.The device success rate and surgery-related complications did not show a statistically significant difference between the two groups(P>0.05 for all).Methods The clinical data of 228 patients with unclosed foramen ovale and coronary heart disease admitted to Shiyan People's Hospital from January 2018 to December 2020 were retrospectively analyzed.They were divided into a one-stop combined operation group and a PFO occlusion group.The location of foramen ovale occluders,thrombus formation,residual shingles,and clinical manifestations were recorded,including recurrent cardiac abnormal embolism events,stroke,bleeding,arrhythmia,sudden death,etc.,during a 24-month follow-up.Kaplan-Meier(K-M)method was used to analyze the survival of all patients with occluded coronary intervention.Results In the one-stop combined operation group,97 patients were implanted with foramen ovale occluders and coronary artery stents,and one patient was abandoned because of femoral artery and femoral vein riding.In the simple PFO occlusion group,190 cases were successfully implanted with foramen ovale occluders.The immediate postoperative occlusion and PCI treatment effects were satisfactory,and there was no thrombus on the surface of instruments,inadvertent tamping plug,or vascular complications during the operation.The follow-up showed no significant increase in events such as bleeding,stroke,residual shunt from the occluder,thrombosis,and myocardial infarction in both groups.The device success rate and surgery-related complications did not show a statistically significant difference between the two groups(P>0.05 for all).There was no significant difference in the incidence of TIA and arrhythmia between the two groups(P=0.305 and 0.140).The log-rank test showed that the survival rate of both groups was higher than 96%,and the survival rate of the K-M survival analysis combined operation group was lower than that of the non-elderly group(P=0.22),but there was no statistical significance.Conclusion For patients with unclosed foramen ovale and coronary heart disease,the concurrent implementation of foramen ovale occlusion combined with coronary artery intervention one-stop treatment indicated the safety and feasibility,which still needs to be further confirmed by multi-center,prospective,large sample study.