Objectives. The purpose of our survey is to analyze the clinical approach used by interventional and imaging cardiologists to diagnose, treat, and follow-up patients with PFO-related left circulation thromboembolism in different parts of the world with particular emphasis on adherence to current guidelines. Background. Firm guidelines do not cover many aspects of PFO-related patient care. Consequently, very disparate approaches exist among clinicians in the real-world. Methods. A 24-item electronic questionnaire was sent directly to experienced cardiology specialists practicing at consultant/attending positions directly involved in PFO closure management in the United States, United Kingdom, Gulf countries, and other countries. There were no unanswered questions. Responses were recorded between October 2019 and July 2020. Results. Seventy-one responses were obtained: 31 from the UK, 19 from the US, 16 from Gulf countries, 2 from Poland, and 1 response from Australia, Italy, and Switzerland. The overall response rate was 76%. Significant differences between regions were noted in the duration of ECG monitoring during the diagnostic process, PFO closure for left circulation thromboembolism other than stroke/transient ischemic attack, and intraoperative use of intracardiac echocardiography. A similar pattern was noted in the lack of routine screening for thrombophilia and the use of the long-term single antiplatelet therapy. Conclusions. The study shows a vast spectrum of opinions on the optimal approach to PFO closure with significant differences between the US, UK, and Gulf countries. The results stress the need for systematic, high-quality data on the diagnostic work-up and follow-up strategies to inform the standardized approach.

中文翻译：

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卵圆孔未闭的现代管理：心脏病专家视角的跨国调查

目标。我们调查的目的是分析介入和影像心脏病专家在世界不同地区诊断、治疗和随访 PFO 相关左循环血栓栓塞患者的临床方法，特别强调遵守当前指南。背景。严格的指南并未涵盖与 PFO 相关的患者护理的许多方面。因此，现实世界中的临床医生之间存在非常不同的方法。方法. 一份包含 24 项的电子问卷直接发送给在美国、英国、海湾国家和其他国家直接参与 PFO 闭合管理的顾问/主治职位的经验丰富的心脏病专家。没有未回答的问题。响应记录在 2019 年 10 月至 2020 年 7 月之间。结果. 共收到 71 份回复：英国 31 份，美国 19 份，海湾国家 16 份，波兰 2 份，澳大利亚、意大利和瑞士 1 份。总体响应率为 76%。在诊断过程中心电图监测的持续时间、除中风/短暂性脑缺血发作以外的左循环血栓栓塞的 PFO 闭合以及心内超声心动图的术中使用方面，区域之间存在显着差异。在缺乏对易栓症的常规筛查和使用长期单一抗血小板治疗方面发现了类似的模式。结论. 该研究显示了关于关闭 PFO 的最佳方法的广泛意见，在美国、英国和海湾国家之间存在显着差异。结果强调需要关于诊断工作和后续策略的系统、高质量数据，以告知标准化方法。