In general, surgical closure of patent foramen ovale (PFO) in patients without inter atrial shunt is unnecessary. There is a b association of PFO with paradoxical embolism (PDE) and ischemic cerebral infarction, and reports on patients with PFO related cryptogenic stroke after coronary artery bypass grafting and various surgical cases of heart or lung are being increasingly published in recent years. These findings powered the interest of anesthesiologists, and cardiothoracic surgeons, in spite of the fact that numerous neurologist and cardiologist have greatly payed attention to these events already. This article surveys the current advance of knowledge to delineate the principal mechanism, clinical presentation, diagnostic strategies and treatment options in patients with PFO, atrial septal aneurysm and PDE, and focuses on careful consideration and effective management of patient who was suddenly presented with a cryptogenic stroke or transient ischemic attack followed by cardiothoracic operations.
Technical advances both in cardiac surgery and relating to anesthesia,cardiopulmonary bypass and myocardial protection have significantly improved the prognosis for patients combined with coronary heart disease and heart valve disease. In addition to technology, variable factors that affect operative survival following combined operation include the severity of valvular disease, the number of coronary vessels affected, impairment of left ventricular function and both age and gender differences. In this article, we review the outcome of surgical intervention for heart valve disease combined with coronary heart disease and discuss future prospects in this field.