Document Detail

Comparison of color flow imaging and peripheral venous saline contrast during transesophageal echocardiography to evaluate right-to-left shunt at the atrial level.
MedLine Citation:
PMID:  10148116     Owner:  NLM     Status:  MEDLINE    
Intravenous injections of agitated saline (contrast) are used to identify right-to-left atrial shunt during transesophageal echocardiography (TEE). Color flow imaging (CFI) with TEE can be used to detect left-to-right atrial shunt but its application to detect right-to-left shunt is not known. We performed CFI and contrast during TEE in 72 patients for detection of right-to-left shunt. Frame-by-frame review of CFI demonstrated discrete laminar jets of the left side of the atrial septum at the lower or upper margin of the fossa ovalis (FO) in 41 (57%) of 72; only 22 had positive contrast. Timing of shunts was late diastolic or early systolic and not related to pulmonary venous inflow. The length of the FO at end-systole was greater in those with positive CFI compared to negative CFI (13.5 +/- 5 vs 11 +/- 4 mm, P = 0.02). CFI was positive for right-to-left shunt in ten of 14 with atrial septal aneurysms. Contrast was positive for right-to-left shunt in 29 (40%) of 72; all but six had positive CFI. The degree of left atrial opacification was minimal in 19 and moderate to severe in ten. FO size was greater in positive versus negative contrast (14 +/- 4 vs 11 +/- 5 mm, P = 0.02). Contrast was positive for shunt in ten of 14 with septal aneurysms. Thus, right-to-left atrial shunt more often occurs with increased FO size and septal aneurysms.(ABSTRACT TRUNCATED AT 250 WORDS)
A D Waggoner; V G Dávila-Román; W E Hopkins; J E Pérez; B Barzilai
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  10     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-04-22     Completed Date:  1993-04-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  59-66     Citation Subset:  T    
Cardiovascular Division, Washington University School of Medicine, St. Louis, MO 63110.
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MeSH Terms
Aged, 80 and over
Contrast Media*
Echocardiography, Doppler / methods
Heart Septal Defects, Atrial / physiopathology,  ultrasonography*
Image Processing, Computer-Assisted*
Middle Aged
Sensitivity and Specificity
Sodium Chloride / diagnostic use
Reg. No./Substance:
0/Contrast Media; 7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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