Abstract: Objective To investigate the safety, efficacy and prognosis of transcatheter closure of patent foramen ovale in patients with patent foramen ovale (PFO) by transatrial septum (AS) puncture. Methods From August 2016 to December 2017, 21 patients underwent transcatheter closure of PFO through foramen ovale in the Department of Cardiology of Hengshui People’s Hospital and the Department of Cardiology of Renmin Hospital of Wuhan University were selected as AS puncture group, and 30 patients with PFO who underwent interventional occlusion through foramen ovale in the same period were selected as control group. The effective occlusion rate, complications, occurrence and prognosis of cardiovascular and cerebrovascular events in PFO occlusion were observed. Results The success rate of transcatheter PFO occlusion was 100%. The average operation time was longer in the AS puncture group than that in the control group (78.0 min±13.4 min vs. 49.2 min±11.9 min). There were no significant differences in the incidences of operative complications during operation and 3 days after operation between the two groups. During the follow-up from 1 to 18 months after operation, there was 1 case of severe residual shunt in the AS puncture group, and the effective occlusion rate was 95.2%. There was no significant difference in the effective occlusion rate between the two groups. There were no significant differences in the main end point events (stroke, peripheral thromboembolism and death) and secondary study end events (new atrial fibrillation, myocardial infarction, PFO related rehospitalization and bleeding) between the two groups. The results of Kaplan-Meier (Log-Rank test) showed that there was no significant difference in the survival rate of ischemic events between the two groups during the follow-up period. Conclusion There are no significant differences in clinical efficacy, complications and ischemic eventsfree survival rate between PFO occlusion via transatrial septum puncture and conventional approach to foramen ovale, and it can be used as a safe technical supplement after the failure of conventional approach.

Key words: foramen ovale, patent, septal occluder device, interventional closure, transseptal puncture, patent foramen ovale, interatrial septal occluder device