Re-conceptualization of the “Chinese Expert Guidelines for the Prevention of Stroke Associated with Patent Foramen Ovale” for the Management of Perioperative Stroke in Patients with Lung Cancer

Abstract

The Chinese Heart Journal published the “Chinese Expert Guidelines for the Prevention of Stroke Associated with Patent Foramen Ovale” (hereafter referred to as “the Guidelines”) in 2021. The Guidelines were initiated by Professor Yushun Zhang of the No.1 Affiliated Hospital of Xi’an Jiaotong University, and 55 domestic experts participated in their discussion and formulation. The Guidelines focus on eight key issues in the prevention of stroke associated with patent foramen ovale (PFO), including definition and epidemiology, anatomical features, ultrasound diagnosis, clinical screening, and prevention and treatment of PFO-associated stroke. The prevention and treatment of PFO-associated stroke include pharmacological prevention, prevention of PFO with transcatheter occlusion and transcatheter occlusion of PFO. Patients with PFO are at elevated risk of perioperative stroke. In China, lung cancer ranks first in incidence among malignant tumors. The number of lung cancer surgeries is increasing each year, and the incidence of PFO in the population is approximately 25%. Although perioperative stroke in patients with lung cancer due to the presence of PFO has rarely been reported, given the high disability rate of stroke, incidence of PFO, and incidence of lung cancer, herein, we consider the Guidelines for the management of perioperative stroke in lung cancer. Our aim is to provide further perspectives in decreasing the risk of perioperative stroke in patients with lung cancer and PFO, to improve their quality of life and increase the safety of surgery.