Diagnosis of patent foramen ovale by transesophageal and transthoracic echocardiography

1993 ◽  
pp. 203-216
Author(s):  
Dirk Hausmann ◽  
Andreas Mügge ◽  
Werner G. Daniel
Keyword(s):  
Transthoracic Echocardiography ◽  
Patent Foramen Ovale ◽  
Foramen Ovale

scholarly journals 479 Usefulness of a new transthoracic echocardiography protocol for identification of patent foramen ovale

2006 ◽  
Vol 7 ◽  
pp. S73-S74
Author(s):  
P CABEZALAINEZ ◽  
A GOMEZMENCHERO ◽  
A CARRILLORUIZ ◽  
R GARCIADELABORBOLLA ◽  
D BARTOLOMEMATEOS ◽  
...  
Keyword(s):  
Transthoracic Echocardiography ◽  
Patent Foramen Ovale ◽  
Foramen Ovale

Abstract 204: Transcranial Doppler Versus Transthoracic Echocardiography for the Detection of Patent Foramen Ovale in Patients With Cryptogenic Cerebral Ischemia: A Systematic Review and Diagnostic Test Accuracy Meta-analysis

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Georgios Tsivgoulis ◽  
Aristeidis H Katsanos ◽  
Theodora Psaltopoulou ◽  
Theodoros Sergentanis ◽  
Alexandra Frogoudaki ◽  
...  
Keyword(s):  
Cerebral Ischemia ◽  
Sensitivity And Specificity ◽  
Transcranial Doppler ◽  
Transthoracic Echocardiography ◽  
Patent Foramen Ovale ◽  
Diagnostic Yield ◽  
Positive Likelihood Ratio ◽  
Receiver Operating Curve ◽  
Test Accuracy ◽  
Foramen Ovale

Background & Purpose: Patent foramen ovale (PFO) can be detected in up to 43% of patients with cryptogenic cerebral ischemia undergoing investigation with transesophageal echocardiography (TEE). The diagnostic value of transthoracic echocardiography (TTE) in the detection of PFO in patients with cryptogenic cerebral ischemia has not been compared with that of transcranial Doppler (TCD) using a comprehensive meta-analytical approach. Methods: We performed a systematic literature review according to PRISMA guidelines to identify all prospective observational studies of patients with cryptogenic cerebral ischemia that provided both sensitivity and specificity measures of TTE, TCD or both compared to the gold standard of TEE. Results: Our literature search identified 35 eligible studies including 3067 patients. The summary sensitivity and specificity for TCD was 96.1% (95% confidence interval: 93.0%-97.8%) and 92.4% (95%CI: 85.5%-96.1%), whereas the respective measures for TTE were 45.1% (95%CI: 30.8-60.3%) and 99.6% (95%CI: 96.5-99.9%). The summary diagnostic odds ratio (DOR) for TCD (DOR=297.97, 95%CI: 131.18-676.83) and TTE (DOR=193.44, 95%CI: 30.38-1231.67) did not significantly differ (z-value=0.418, p=0.676). TTE was superior in terms of higher positive likelihood ratio values (LR+= 106.61, 95%CI: 15.09-753.30 for TTE vs. LR+=12.62, 95%CI: 6.52-24.43 for TCD; p=0.043), while TCD yielded lower negative positive likelihood values (LR- = 0.04, 95%CI: 0.02-0.08) compared to TTE (LR- =0.55, 95%CI: 0.42-0.72; p<0.001). Finally, the area under the summary receiver operating curve was significantly greater (p<0.001) in TCD (AUC=0.98, 95%CI: 0.97-0.99; Figure A) compared to TTE studies (AUC=0.86, 95%CI: 0.82-0.89; Figure B). Conclusions: TCD is more sensitive but less specific compared to TTE for the detection of PFO in patients with cryptogenic cerebral ischemia. The overall diagnostic yield of TCD appears to outweigh that of TTE.

OP-035: TRANSTHORACIC ECHOCARDIOGRAPHY GUIDANCE DURING PERCUTANEOUS CLOSURE OF PATENT FORAMEN OVALE

2011 ◽  
Vol 147 ◽  
pp. S46-S47
Author(s):  
E.B. Kaya ◽  
K. Aytemir ◽  
S. Ozkutlu ◽  
H. Yorgun ◽  
A.H. Ates ◽  
...  
Keyword(s):  
Transthoracic Echocardiography ◽  
Patent Foramen Ovale ◽  
Percutaneous Closure ◽  
Foramen Ovale

Exercise after SCUBA diving increases the incidence of arterial gas embolism

2013 ◽  
Vol 115 (5) ◽  
pp. 716-722 ◽  
Author(s):  
Dennis Madden ◽  
Mislav Lozo ◽  
Zeljko Dujic ◽  
Marko Ljubkovic
Keyword(s):  
Transthoracic Echocardiography ◽  
Patent Foramen Ovale ◽  
Maximal Exercise ◽  
Scuba Diving ◽  
Foramen Ovale ◽  
Gas Embolism ◽  
Heavy Equipment ◽  
Pulmonary Microcirculation ◽  
The Right ◽  
Ergometry Test

Arterialization of gas bubbles after decompression from scuba diving has traditionally been associated with pulmonary barotraumas or cardiac defects, such as the patent foramen ovale. Recent studies have demonstrated the right-to-left passage of bubbles through intrapulmonary arterial-venous anastamoses (IPAVA) that allow blood to bypass the pulmonary microcirculation. These passages open up during exercise, and the aim of this study is to see if exercise in a postdiving period increases the incidence of arterialization. After completing a dive to 18 m for 47 min, patent foramen ovale-negative subjects were monitored via transthoracic echocardiography, within 10 min after surfacing, for bubble score at rest. Subjects then completed an incremental cycle ergometry test to exhaustion under continuous transthoracic echocardiography observation. Exercise was suspended if arterialization was observed and resumed when the arterialization cleared. If arterialization was observed a second time, exercise was terminated, and oxygen was administered. Out of 23 subjects, 3 arterialized at rest, 12 arterialized with exercise, and 8 did not arterialize at all even during maximal exercise. The time for arterialization to clear with oxygen was significantly shorter than without. Exercise after diving increased the incidence of arterialization from 13% at rest to 52%. This study shows that individuals are capable of arterializing through IPAVA, and that the intensity at which these open varies by individual. Basic activities associated with SCUBA diving, such as surface swimming or walking with heavy equipment, may be enough to allow the passage of venous gas emboli through IPAVA.

scholarly journals Importance of Contrast Transthoracic Echocardiography for Evaluating Large Right-to-Left Shunt in Patent Foramen Ovale Associated with Cryptogenic Stroke

2021 ◽  
Author(s):  
Yoichi Takaya ◽  
Rie Nakayama ◽  
Teiji Akagi ◽  
Fumi Yokohama ◽  
Takashi Miki ◽  
...  
Keyword(s):  
High Risk ◽  
Transesophageal Echocardiography ◽  
Transthoracic Echocardiography ◽  
Patent Foramen Ovale ◽  
Transcatheter Closure ◽  
Cryptogenic Stroke ◽  
Effective Therapy ◽  
Foramen Ovale

Abstract Transcatheter closure of patent foramen ovale (PFO) is an effective therapy for preventing cryptogenic stroke (CS). The identification of high-risk PFO, which is more likely to be linked to CS, is essential. This study aimed to assess the accuracy of contrast transthoracic echocardiography (TTE) for evaluating large right-to-left (RL) shunt. We enrolled 119 patients with or without CS who were confirmed to have PFO. The severity of RL shunt evaluated by contrast TTE and transesophageal echocardiography (TEE) was classified as follows: small (<10 microbubbles), moderate (10–20 microbubbles), and large (>20 microbubbles). With contrast TTE, large RL shunt was observed in 94 (79%) of 119 patients, including 66 of 74 with CS and 28 of 45 without CS. With contrast TEE, large RL shunt was observed in 33 (28%) patients, including 26 with CS and 7 without CS. Contrast TTE showed large RL shunt more frequently than contrast TEE (p < 0.01). Large RL shunt evaluated by contrast TTE had a sensitivity of 89% and an accuracy of 70% for the association with CS, whereas large RL shunt evaluated by contrast TEE had a sensitivity of 35% and an accuracy of 56%. Accuracy was significantly greater in contrast TTE than in contrast TEE (p = 0.02). In conclusion, contrast TTE identified large RL shunt more frequently. Large RL shunt evaluated by contrast TTE provided greater accuracy for the association with CS. Our findings suggest that contrast TTE is valuable for evaluating large RL shunt as high-risk PFO.

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