Prevalence of atrial septal defects and patent foramen ovale in a cohort of sudden cardiac death patients undergoing autopsy.

Autor: Fahy L; Baker Heart and Diabetes Institute, Prahran, VIC, Australia; Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia. Electronic address: louise.fahy@baker.edu.au., Rowe S; Baker Heart and Diabetes Institute, Prahran, VIC, Australia; Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia., Nehme Z; Ambulance Victoria, Doncaster, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia., Stub D; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Cardiology, Alfred Hospital, Prahran, VIC, Australia., Zentner D; Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC, Australia., James P; Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC, Australia., Pflaumer A; Department of Cardiology, Royal Children's Hospital, Parkville, VIC, Australia; Murdoch Children's Research Institute and University of Melbourne, Parkville, VIC, Australia; Department of Population Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia., Connell V; Department of Cardiology, Royal Children's Hospital, Parkville, VIC, Australia., Semsarian C; Agnes Ginges Centre for Molecular Cardiology, Centenary Institute and University of Sydney, Sydney, NSW, Australia., Ingles J; Department of Population Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia., La Gerche A; Baker Heart and Diabetes Institute, Prahran, VIC, Australia; Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Faculty of Medicine, Dentistry and Health Sciences, Melbourne University, Parkville, VIC, Australia., Paratz ED; Baker Heart and Diabetes Institute, Prahran, VIC, Australia; Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Faculty of Medicine, Dentistry and Health Sciences, Melbourne University, Parkville, VIC, Australia.
Jazyk: angličtina
Zdroj: Journal of cardiology [J Cardiol] 2024 Jun; Vol. 83 (6), pp. 390-393. Date of Electronic Publication: 2023 Sep 19.
DOI: 10.1016/j.jjcc.2023.09.006
Abstrakt: Background: Patent foramen ovale (PFO) and atrial septal defects (ASD) have been described in up to 30 % of subjects in autopsy series but contemporary data are scarce. It is important to confirm the prevalence of ASD/PFO in the general population given the potential associated stroke risk and the increasing availability of intervention via PFO closure.
Methods: A state-wide prospective out-of-hospital cardiac arrest registry (OHCA) identified all patients aged 1 to 50 years who experienced OHCA in Victoria, Australia from April 2019 to April 2022 and subsequently underwent autopsy with a cardiac cause of death identified. Autopsy was performed including visual description of any ASD and identification of probe patency of foramen ovale.
Results: A total of 517 patients underwent autopsy in the setting of sudden cardiac death; 36 patients (6.9 %) had a probe-patent foramen ovale, 2 patients (0.4 %) had secundum ASD, and 2 patients (0.4 %) had both a PFO and ASD (1 of whom had undergone percutaneous repair of both lesions). Twelve patients (2.3 %) had a prior history of cerebrovascular accident either recorded on medical history or detected on neuropathological examination; however none of these patients had a PFO or ASD.
Conclusions: The combined rate of PFO and ASD in a cohort of 517 patients undergoing autopsy was 7.9 %. None of these patients had experienced a cerebrovascular accident. This rate of PFOs appears lower than earlier reports and raises the possibility that the relative risk of an associated stroke could be higher than previously estimated.
Competing Interests: Declaration of competing interest None.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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