"What Causes the Persistence of Patent Foramen Ovale in Infants and Young Children?"

Infant Patent Foramen Ovale

The infant patent foramen ovale (PFO) refers to a blood flow channel between the left and right atria during fetal life, which typically closes gradually after birth. Failure of the infant PFO to close may be attributed to maternal factors, genetic predisposition, environmental factors during fetal development, fetal developmental abnormalities, congenital heart disease, and other reasons. It is recommended to seek medical attention promptly, and based on the underlying cause, corresponding measures should be taken under medical guidance. Details are as follows:

1. Maternal Factors

Conditions such as diabetes and rubella during pregnancy may increase the risk of an infant's PFO remaining open. It is advised to improve the mother's health status, including managing diabetes and treating rubella, potentially with medications like acarbose, metformin, acyclovir, or ganciclovir, as prescribed by a doctor. Additionally, maintaining healthy habits like smoking and alcohol cessation can help reduce the risk.

2. Genetic Factors

Research indicates that PFO persistence exhibits a familial clustering, suggesting genetics may play a role. Currently, there are no specific medications for PFO caused by genetic factors. However, fetal echocardiography during pregnancy is recommended for early detection and management.

3. Environmental Factors During Fetal Development

Certain medications, chemicals, and radiation can affect fetal heart development, leading to PFO persistence. Pregnant women should avoid exposure to harmful environments, including radiation and chemicals, and refrain from using medications detrimental to fetal development.

4. Fetal Developmental Abnormalities

Abnormalities in fetal development, such as cardiac hypoplasia, can cause PFO persistence. Mild cases may close spontaneously with infant growth, while severe cases may require surgical interventions like transcatheter closure, minimally invasive surgery through the chest wall, or transvenous catheterization, under medical guidance. Medications like ceftriaxone, cefixime, ibuprofen, paracetamol, or warfarin may be prescribed to manage symptoms or disease progression.

5. Congenital Heart Disease

Congenital heart disease can lead to PFO persistence. Treatment options include surgery and medication, with surgery being the primary approach. Surgical methods include cardiac closure, shunts, corrections, balloon valvuloplasty, and transcatheter closure. Medications like furosemide, hydrochlorothiazide, and metoprolol may be prescribed in conjunction with surgical treatment.

Mothers should pay attention to feeding methods and pace to prevent choking or asphyxiation. During breastfeeding, maintain a proper position with the infant's head and body aligned, avoid lying flat, and hold the baby upright for a while after feeding, gently patting the back to burp.

Symptoms like cyanosis of the lips, slow weight gain, or stunted growth should raise concerns about PFO persistence and prompt medical evaluation.