Objective To investigate the diagnosis and treatment of pilots with patent foramen ovale resulting in encephalomalacia foci and discuss the aeromedical assessment principles.Methods The clinical manifestations,cranial MRI,cardiac ultrasound and transesophageal echocardiography of a pilot with patent foramen ovale and encephalomalacia foci were retrospectively analyzed,and the relevant literatures were reviewed.Results The patient was a male fighter pilot,28 years old,without clinical symptoms and complaints of discomfort.A left temporal pole arachnoid cyst(2.18 cm×1.11 cm)and a left frontal brain softening foci(1.80 cm×3.50 cm×3.30 cm)were detected by cranial MRI during physical examination,and patent foramen ovale was detected by transesophageal echocardiography and foam test after admission.The oval foramen was occluded under local anesthesia.The patient was well-recovered after surgery and without discomfort.The cardiac ultrasound recheck showed normal myocardial echoes in the septum and left ventricular wall,no abnormalities in wall thickness and motion amplitude,and coordinated ventricular wall motion.Strong echogenicity of the blocker was seen in the middle of the atrial septum,and the position of the blocker was normal.The aeromedical assessment conclusion of the patient was waiver to flight.Conclusions The patent foramen ovale should be screened when pilot is diagnosed as encephalomalacia foci or cerebral infarction.The regular reexamination and follow-up should be conducted for the transcatheter occlusion of patent foramen ovale.Pilots could be waivered when they have no clinical symptoms and signs,no arrhythmias and at proper position in dynamic electrocardiogram and submaximal treadmill exercise test,no residual shunt,valve regurgitation,or occluder erosion in imaging examination,and normal cardiac function,reserve function,and regulatory function,normal pressurized breathing and without arrhythmias in centrifuge run,and the grounding observation period is not less than 6 months.
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