Safety and Efficacy of Cera™ Patent Foramen Ovale Occluders.

Prior treatment

• Mitral/aortic disease: including mitral stenosis or severe mitral regurgitation of any cause, severe aortic stenosis or severe aortic regurgitation, mitral or aortic valve vegetations or prior valve replacement surgery;
• Participate in clinical trials of other drugs or medical devices within three months.

Other illness

• Patients with intracardiac thrombosis or tumor, intracardiac vegetations;
• Acute myocardial infarction or unstable angina within 6 months;
• Left ventricular aneurysm formation or left ventricular wall movement disorder;
• Patients with active endocarditis or other untreated infections or other hemorrhagic diseases;
• Pulmonary hypertension or patent foramen ovale was a special channel;
• Uncontrolled hypertension (\> 180/100 mmHg);
• Contraindication of antiplatelet or anticoagulant therapy, such as severe bleeding within 3 months, obvious retinopathy, history of other intracranial bleeding, and obvious intracranial diseases;
• Coronary heart disease, hypertension, diabetes and other vascular diseases that are poorly controlled by drugs or other means;
• Thrombosis exists at the location or route of implantation;
• Malignant neoplasms or other diseases with a life expectancy of less than 2 years;

Lab values

• Dilated cardiomyopathy, LVEF \< 35%, or other severe heart failure;
• Liver and kidney function impairment (ALT or AST \> 3 times the upper limit of normal value, serum creatinine (Cr) \> 2 times the upper limit of normal value);

Other

• Carotid atherosclerotic stenosis was determined by the investigator based on CT or vascular ultrasound (\> 50%);
• Large cerebral infarction occurred within 4 weeks (MR/CT or DWI image ASPECTS score \<6 points or infarction volume ≥70 ml or infarction area \> 1/3 middle cerebral artery blood supply area);
• Patients with right-to-left shunt due to other causes, including atrial septal defect or perforated diaphragm;
• Atrial fibrillation/atrial flutter (chronic or intermittent);
• Pregnant or planning to become pregnant during the trial;
• The investigator determined that the patient was not suitable for implantation of PFO occluder (for example, the diameter of the base of the atrial septal tumor ≥25mm and the size of the foramen ovale ≥5mm) or the patient has contraindications for implantation of PFO occluder;
• Patients who could not be followed up during the trial;

• Patients aged 18-60 years;
• Be able to understand the purpose of the experiment, voluntarily participate in the experiment and sign the informed consent;
• Patent foramen ovale was confirmed by at least one of the following conditions exists:
  • Patent foramen ovale was confirmed by Transthoracic echocardiography (TTE) or Transesophageal echocardiography (TEE);
  • The presence of medium or large right-to-left shunt was confirmed by Right-heart acoustic contrast (cTTE or cTCD);
• It meets the clinical status of patent foramen ovale plugging indication, and at least one of the following conditions exists:
  • Cryptogenic stroke complicated with patent foramen ovale, combined with one or more clinical risk factors;
  • Cryptogenic stroke complicated with patent foramen ovale, combined with one or more anatomical risk factors of patent foramen ovale;
  • Cryptogenic stroke complicated with patent foramen ovale, with clear deep vein thrombosis or pulmonary embolism, and not suitable for anticoagulant therapy;
  • Cryptogenic stroke complicated with patent foramen ovale, but still recurred with antiplatelet or anticoagulant therapy.