European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism

被引：167

作者：

Pristipino, Christian ^{[1
]}

Sievert, Horst ^{[2
,3
,4
]}

D'Ascenzo, Fabrizio ^{[5
]}

Mas, Jean Louis ^{[6
]}

Meier, Bernhard ^{[7
]}

Scacciatella, Paolo ^{[5
]}

Hildick-Smith, David ^{[8
]}

Gaita, Fiorenzo ^{[5
]}

Toni, Danilo ^{[9
]}

Kyrle, Paul ^{[10
]}

Thomson, John ^{[11
]}

Derumeaux, Genevieve ^{[12
]}

Onorato, Eustaquio ^{[13
]}

Sibbing, Dirk ^{[14
]}

Germonpre, Peter ^{[15
]}

Berti, Sergio ^{[16
]}

Chessa, Massimo ^{[17
]}

Bedogni, Francesco ^{[17
]}

Dudek, Dariusz ^{[18
]}

Hornung, Marius ^{[2
]}

Zamorano, Jose ^{[19
]}

Omede, Pierluigi ^{[5
]}

Ballocca, Flavia ^{[5
]}

Barbero, Umberto ^{[5
]}

Giordana, Francesca ^{[5
]}

Gili, Sebastiano ^{[5
]}

Iannaccone, Mario ^{[5
]}

Capodannno, Davide ^{[20
]}

Valgimigli, Marco ^{[7
]}

Byrne, Robert ^{[21
]}

Akagi, Teiji ^{[22
]}

Carroll, John ^{[23
]}

Dalvi, Bharat ^{[24
]}

Ge, Junbo ^{[25
]}

Kasner, Scott ^{[26
]}

Michel-Behnke, Ina ^{[27
]}

Pedra, Carlos ^{[28
]}

Rhodes, John ^{[29
]}

Sondergaard, Lars ^{[30
]}

Thomassen, Lars ^{[31
]}

Biondi-Zoccai, Giuseppe G. L. ^{[32
,33
]}

机构：

[1] ASL Roma 1, S Filippo Neri Hosp, Rome, Italy

[2] CardioVasc Ctr CVC Frankfurt, Frankfurt, Germany

[3] Anglia Ruskin Univ, Chelmsford, Essex, England

[4] Univ Calif San Francisco, San Francisco, CA 94143 USA

[5] Univ Turin, Citta Salute & Sci Hosp, Turin, Italy

[6] Univ Paris 05, Hop St Anne, Paris, France

[7] Univ Hosp, Bern, Switzerland

[8] Brighton & Sussex Univ Hosp, Sussex Cardiac Ctr, Brighton, E Sussex, England

[9] Sapienza Univ, Hosp Policlin Umberto I, Rome, Italy

[10] Med Univ, Vienna, Austria

[11] Leeds Gen Infirm, Leeds, W Yorkshire, England

[12] Hop Henri Mondor, Fac Med Creteil, Creteil, France

[13] Humanitas Gavazzeni, Bergamo, Italy

[14] Ludwig Maximilians Univ Munchen, Campus Grosshadern, Munich, Germany

[15] Mil Hosp Brussels, Brussels, Belgium

[16] Heart Hosp, Massa, Italy

[17] Univ Hosp, Policlin San Donato, Milan, Italy

[18] Univ Hosp, Krakow, Poland

[19] Univ Hosp Ramon y Cjal, Madrid, Spain

[20] Univ Catania, Azienda Osped Univ Policlin Vittorio Emanuele, Catania, Italy

[21] Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany

[22] Okayama Univ Hosp, Okayama, Japan

[23] Univ Colorado Hosp, Denver, CO USA

[24] Glenmark Cardiac Ctr, Mumbai, Maharashtra, India

[25] Shanghai Inst Cardiovasc Dis, Shanghai, Peoples R China

[26] Univ Penn, Philadelphia, PA 19104 USA

[27] Univ Vienna, Kinderherzzentrum, Vienna, Austria

[28] Dante Pazzanese Inst Cardiol, Sao Paulo, Brazil

[29] Nicklaus Childrens Hosp, Miami, FL USA

[30] Rigshosp, Copenhagen, Denmark

[31] Haukeland Hosp, Bergen, Norway

[32] Sapienza Univ Rome, Latina, Italy

[33] IRCCS Neuromed, Dept AngioCardioNeurol, Pozzilli, Italy

来源：

EUROPEAN HEART JOURNAL | 2019年 / 40卷 / 38期

关键词：

D O I：

10.1093/eurheartj/ehy649

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The presence of a patent foramen ovale (PFO) is implicated in the pathogenesis of a number of medical conditions; however, the subject remains controversial and no official statements have been published. This interdisciplinary paper, prepared with involvement of eight European scientific societies, aims to review the available trial evidence and to define the principles needed to guide decision making in patients with PFO. In order to guarantee a strict process, position statements were developed with the use of a modified grading of recommendations assessment, development, and evaluation (GRADE) methodology. A critical qualitative and quantitative evaluation of diagnostic and therapeutic procedures was performed, including assessment of the risk/benefit ratio. The level of evidence and the strength of the position statements of particular management options were weighed and graded according to predefined scales. Despite being based often on limited and non-randomised data, while waiting for more conclusive evidence, it was possible to conclude on a number of position statements regarding a rational general approach to PFO management and to specific considerations regarding left circulation thromboembolism. For some therapeutic aspects, it was possible to express stricter position statements based on randomised trials. This position paper provides the first largely shared, interdisciplinary approach for a rational PFO management based on the best available evidence.

引用

页码：3182 / 3195

页数：14