Text, photo/ Yangcheng Evening News all-media reporter Xue Renzheng correspondent Wang Hui Bai Tian
Recently, Xiao Liang, a 23-year-old citizen of Guangzhou, had a sudden cerebral infarction and was sent by his family to the Third Affiliated Hospital of Guangzhou Medical University (hereinafter referred to as the "Third Hospital of Guangzhou Medical University") for treatment. Stroke at a young age is rare, and what Xiao Liang and his family did not expect was that the "culprit" that caused the cerebral infarction was congenital heart disease - the oval hole was not closed. At present, after the interventional surgery treatment of the cardiology team of the hospital, Xiaoliang has recovered well and has been successfully discharged from the hospital.
The sudden cerebral infarction was caused by congenital heart disease
Xiao Liang, who is usually healthy and has no bad living habits, never expected that he was only 23 years old, and he would have a brain infarction.
One day in mid-March, when Xiao Liang was lying on the bed and reaching for her mobile phone, she suddenly felt that her left side of her body was not strong, and then she fell off the bed, and her family found out and quickly sent her to the emergency department of the Third Hospital of Guangdong Medical College.
In the emergency department, a flat CT scan of the head and cervical spine showed large-scale cerebral infarction in the right frontal parietal lobe and the right basal ganglia area, and then transferred to the neurology stroke center through the green channel for treatment.
Due to the timely delivery, the stroke center carried out intravenous thrombolysis for the patient within the window time, and then hospitalized in the neurology department, liang Yanling, chief physician of the department of neurology, found that Xiaoliang did not have high risk factors for traditional cerebral infarction such as hypertension, diabetes, hyperlipidemia, atrial fibrillation, etc., and carried out further examinations, especially after doing cardiac ultrasound, ultrasound prompted the patient to have "abnormal shunting from the right atrium to the left atrium", Director Liang Yanling speculated with rich experience in diagnosis and treatment that the patient may be a stroke caused by patent foramen ovale of the heart.
"Due to the presence of venous microembolos in the human blood flow, under normal circumstances, when the blood flows into the lungs, they are metabolized, and the patient's oval foramen is not closed, causing the right heart pressure to be higher than the left heart, the venous microembolos may abnormally shunt to the heart, brain, kidneys and other organs through the oval hole, and the unmetabolized microembolites reach the circulatory artery system of the body, which can easily lead to blockage and infarction of related brain, kidney, spleen and other organs." Lin Yuhui, deputy chief physician of the Department of Cardiology, explained.
Subsequently, the hospital cardiovascular experts found through transesophageal echocardiography that the primary and secondary septum of the trabecular heart "has a gap, about 5.3 mm long and about 2.4 mm wide", indicating that the trabecular heart oval foramen is not closed, further clarifying the cause.
After full communication with the patient and his family, the cardiovascular specialist decided to perform minimally invasive interventional occlusion surgery for him.
Transesophageal echocardiography shows the patient's foramen oval oval
"Heart repair" actually requires surgery from the thigh
After full preoperative preparation, under the leadership of Director Chen Ximing, the intervention team of the Department of Cardiology, led by Lin Yuhui, Deputy Chief Physician He Xiaoqing and Deputy Chief Physician Huang Jionghua, jointly performed patent foramen oval (PFO) interventional occlusion for the patient, and the operation ended in about 20 minutes, and the process was very smooth.
The cardiac ultrasound was reviewed the day after surgery, and the results suggested that "no obvious abnormal colored blood flow was seen in the heart cavity". The patient recovered well after the operation and has now been successfully discharged from the hospital. The hospital will also conduct regular follow-up visits to patients.
Postoperative ultrasound imaging shows normal left ventricular systolic function
According to Chen Ximing, the patent foramen oval (PFO) interventional occlusion is to puncture the femoral vein from the inguinal area at the root of the thigh of the patient, follow the body's own large vascular path to deliver the occlusion device and fix it at the unclosed foramen of the oval, and the main part of the PFO occlusion takes only 5-10 minutes. Percutaneous interventional PFO occlusion also has the advantages of safety, effectiveness and low trauma, and only the needle-eye-sized puncture wound is left at the root of the patient's thigh after surgery, and the average PFO closure rate can exceed 98% in the six months after surgery.
Postoperative X-ray of the patient shows the location of the blocker
With the advancement of medical technology, especially the development of cardiac catheterization technology, the promotion of patent foramen oval (PFO) occlusion can reduce the recurrence rate of stroke and the probability of paralysis, reduce the cost of related treatment and rehabilitation, and improve the personal quality of life of patients. At the same time, with the development of cardiac catheterization technology, a considerable number of left-to-right shunt congenital heart disease, such as patent ductus arteriosus, AV septal defect, ventricular septal defect, etc. can be radically cured by interventional treatment.
One in four has patent foramen
Patent foramen oval is a special type of atrial septal traffic that is a common congenital cardiac malformation that occurs in about 26% of the normal population. The foramen ovale is generally closed in the first year after birth, and if the foramen of children older than 3 years old is still not closed, the foramen ovale is not closed, and 20% to 25% of adults do not completely close. Patent foramen oval is currently the most common congenital heart abnormality in adults, and 1 in about 4 people in the normal population can be detected. However, due to the fact that the foramen of the oval is not closed and there are no obvious symptoms, it is difficult to hear the murmur, and the ELECTROCardiogram and chest X-ray are difficult to find, which can generally be diagnosed by cardiac ultrasound.
The clinical manifestations of patent foramen oval are diverse, with unexplained strokes and migraines, but also transient ischemic attacks, unexplained dizziness and syncope, and even non-atherosclerotic myocardial infarction.
Lin Yuhui reminded that for people with the above related symptoms, we should pay attention to the hospital as soon as possible to check and treat, once the oval foramen is confirmed, it can be treated in time through interventional occlusion, which can not only improve migraine, unexplained syncope and other symptoms after treatment, but also effectively prevent the occurrence of critical diseases such as stroke and myocardial infarction, and avoid tragedy. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Wang Moyi