Objective:To explore the performance of agitated saline contrast echocardiography(ASCE)in patients with patent foramen ovale(PFO)and the relationship of that with the prognosis of treatment of interventional closure.Methods:A total of 70 patients with PFO who were hospitalized in Haikou People's Hospital from October 2020 to August 2022 were selected as research objects.All patients were treated with interventional closure,and the preoperative and postoperative ASCE performances,as well as the ASCE grading were recorded.All patients were followed up for 12 months after operation,and then they were assessed to confirm whether there was any residual diversion.After that,the changes of Headache Impact Test-6 Scale(HIT-6)score between before and after operation were compared.Results:In the ASCE image characteristics and the morphology of the foramen ovale of 70 PFO patients,22 cases(31.42％)were type Ⅰ patients,whose diameter of the foramen ovale was less than 1 mm,and the patent foramen ovale without closure appeared fine needle-like,and 28 cases(40.00％)were type Ⅱ patients,whose diameter of the foramen ovale was between 2 and 3mm,and the patent foramen ovale without closure appeared tunnel-like,and 20 cases(28.57％)were type Ⅲ patients,whose diameter of the foramen ovale was≥3mm,and the patent foramen ovale without closure appeared pouch-like.The results of re-examined ASCE of 70 patients indicated that the positions of the occluder were favorable in type Ⅰ,Ⅱ and Ⅲ patients,which closely attached to the atrial septum.There was not residual blood flow to pass through the atrial septum in all patients.Preoperative ASCE RLS grading showed that 20 cases(28.57％)were rest RLS grade 0,and 25 cases(35.71％)were grade I,and 14 cases(20.00％)were grade Ⅱ,and 11 cases(15.71％)were grade Ⅲ.The post classification of Waals maneuver indicated 30 cases(42.85％)were RLS grade I,and 25 cases(35.71％)were RLS grade Ⅱ,and 15 cases(21.4％)were RLS grade Ⅲ.Postoperative ASCE RLS grading showed that there was RLS in all patients,and the difference in RLS grading between before and after surgery was statistically significant(x2=85.783,P<0.05).In the 70 patients,ASCE results showed that the front-back diameter of left atrium of patients at 0 grade RLS was significantly less than that of patients at≥1 grade RLS,and the difference was statistically significant(t=8.783,P<0.05).There were no adverse events such as bleeding,infection,thromboembolism,stroke and occluder detachment occurred in all patients after surgery.The preoperative HIT-6 score of 70 patients was(73.85±5.79)points,and the scores decreased respectively to(50.82±6.57)and(39.06±4.69)points at the 1st and 6th months after surgery,and the difference of HIT-6 scores between them was significant(t=3.783,P<0.05).The results of re-examined ASCE at the 1st and 6th months after surgery showed that there was no RLS diversion phenomenon in 70 patients,and the results of trans thoracic echocardiography(TTE)indicated that RLS diversion existed in two patients.Conclusion:The diversion grade can be confirmed after PFO patients undergo the combined examination of ASCE,rest status examination and Waals maneuver,which has a certain of reference value in preoperative assessment for disease condition and in postoperative judgement for curative effect.
维普
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