Although there are no symptoms of patent foramen ovale, according to a survey, about one quarter of the population has patent foramen ovale. Usually it is considered to be unnecessary to treat. However, in recent years, it has been found that the foramen ovale is closely related to unexplained cerebral embolism, diving decompression sickness, migraine and other diseases, so some scholars believe that repair treatment should be performed for people with a history of unexplained cerebral embolism, divers, astronauts and people with intractable migraine combined with foramen ovale. According to a survey, about 20% to 25% of adults have incomplete closure of the foramen ovale, which becomes a functional living valve. Because the left atrial pressure is higher than the right atrial pressure, the foramen ovale valve is closed and the patient has no clinical symptoms and usually does not require treatment. When frequent coughing and constipation occur, the right atrial pressure will be higher than the left atrial pressure, and the weak primary septum on the left side will be pushed open, i.e., a right-to-left shunt will occur, and emboli from the venous system may reach the cerebral artery through the unclosed foramen ovale and cause cerebral infarction, which is also called paradoxical embolism. A large number of foreign studies have shown that the incidence of unexplained cerebral ischemic events is significantly higher in people with unclosed foramen ovale than in people without unclosed foramen ovale. Therefore, in patients with a history of unexplained cerebral ischemia who also have an unclosed foramen ovale and a right-to-left shunt, the foramen ovale should be occluded to prevent future problems. Interventional treatment is a kind of minimally invasive treatment without incision, in which a special blocker is inserted deep into the atrial septum of the heart to block the unclosed foramen ovale through the blood vessel, and the technical success rate is nearly 100%. In China, specialists often consider vascular factors such as cerebrovascular and aortic factors and cardiogenic factors such as endocarditis, rheumatic valve disease, left atrial mucinous tumor, left atrial appendage thrombus, and atrial fibrillation in the etiology of cerebral infarction, but do not pay enough attention to congenital heart disorders such as foramen ovale and atrial septal expansion tumor. These diseases have high technical requirements for detection, and the detection rate of conventional transthoracic ultrasound and transesophageal ultrasound alone is less than 10%. The simultaneous use of transesophageal ultrasound and acoustic imaging techniques is the most effective approach available, with a detection rate close to 100%. Therefore, this test should be used to confirm the diagnosis of patent foramen ovale and atrial septal tumor in patients with common high-risk stroke factors and difficult to identify causes, especially in young patients with cerebral ischemia. Because the foramen ovale is a channel between the right and left heart, it may divert blood between the left and right heart. Usually, the pressure in the left heart is higher than in the right heart, and a small amount of arterial blood from the left heart flows into the right heart, i.e., a left-to-right shunt, which usually does not cause symptoms. During increased pressure in the right heart (e.g., coughing, breath-holding, diving), venous blood from the right heart flows into the left heart, i.e., a right-to-left shunt. The right-to-left shunt is also usually asymptomatic, but if some material from the right heart system (venous system) enters the left heart with the blood flow it can produce symptoms called reverse blood flow or embolism. Including: 1, thromboembolism: some unexplained cerebral embolism is caused by the oval foramen not closed, because the venous system blood flow is slower than the artery, easy to form thrombus, such as the lower extremity of the venous thrombus can pass through the oval foramen to form cerebral embolism. Irregular blood flow near the foramen ovale can form a thrombus called atrial septoma. The atrial septal tumor can also form cerebral embolism after dislodging. 2.Air: Decompression sickness in divers is caused by air embolism entering the left heart artery system through the foramen ovale. 3.Fat: Fat embolus is formed after surgery, and fat embolism causes neurological dysfunction. 4, hypoxemia: When there is a right heart infarction, pericardial effusion and severe tricuspid regurgitation, etc., the increased pressure in the right heart leads to more right-to-left shunts and symptoms of dyspnea and dizziness due to the low oxygenated blood flow into the left heart. When it comes to this, some people ask: What is the relationship between migraine and unclosed foramen ovale? The typical migraine is characterized by throbbing pain on one side of the head, accompanied by photophobia, vomiting and nausea, often preventing normal work and study for one day or longer. A few migraine patients have aura (sensory signals before each attack): flash hallucinations and other visual deficits are common. Migraines are associated with genetics and estrogen. However, the exact etiological mechanisms are not yet clear. The first person to discover the link between migraines and foramen ovale nonunion was Roman Sztajzel, a neurologist at the University Hospital of Geneva, who received a letter from a patient in 1999 thanking him for curing his migraines of more than 30 years. It turned out that the patient had suffered a second cerebral embolism, and tests revealed an unclosed foramen ovale, in order to reduce her chances of having another cerebral embolism. The hospital surgically blocked the foramen ovale for her, and the patient’s migraine disappeared immediately. Since then, a lot of attention has been paid to the relationship between patent foramen ovale and migraine. Soon after, Italian scholars reported a very high incidence of patent foramen ovale in headache patients, and Wilmshurst in the UK reported that blocking the foramen ovale in patients with decompression sickness made their migraines disappear. More recently, Anzola et al. found that patients with migraine with aura were more than twice as likely to develop patent foramen ovale and had a much higher incidence of right-to-left shunts in the quiet state than did patients without migraine with patent foramen ovale. The exact mechanism by which migraine occurs in patients with patent foramen ovale is unknown, and it is thought that it may be related to the flow of some substance from venous blood into the arterial system to reach the brain. Therefore, if you have a migraine, it is essential to further examine for patent foramen ovale. Three commonly used methods to check for patent foramen ovale are transthoracic ultrasound, transesophageal ultrasound, and transcranial Doppler microbubble testing. Transthoracic ultrasound is simple and noninvasive, but the detection rate is low and can only reach 80% with an experienced sonographer in conjunction with acoustic imaging. The detection rate of transesophageal ultrasound and transcranial Doppler microbubble experiment are both quite high, reaching more than 95%, which is called the gold standard for detecting oval foramen ovale failure; some reports report that the detection rate of microbubble method transcranial Doppler ultrasound reaches 99%. Transesophageal ultrasound is invasive, the examination process is painful, and the patient is not easy to cooperate with the examination, all of which limit its application. Transcranial Doppler microbubble test overcomes these disadvantages and is the most popular method for detecting patent foramen ovale. The two methods of treatment for patent foramen ovale are surgical suturing of the foramen ovale and transcatheter occlusion. The latter has a tendency to gradually replace the former because it reduces the pain of open-heart surgery and extracorporeal circulation and has a high success rate. If one is found to have an unclosed foramen ovale, not every patient should be treated. Because the incidence of patent foramen ovale is one quarter of the population, most are asymptomatic. If you find a patent foramen ovale, consult your doctor and consider surgery only for a subset of patent foramen ovale with large fractional flow and complicating symptoms. There are no uniform criteria for treatment of oval foramen nonocclusion in migraine patients, but a comprehensive consideration must be made. Ovarian foramen occlusion treatment offers a new possible approach to the treatment of migraine, so that migraine may not be a lifelong disorder.