Document Detail


Transesophageal contrast echocardiography and color flow mapping: methods of choice for the detection of shunts at the atrial level?
MedLine Citation:
PMID:  1462912     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The detection of shunts at the atrial level is important, and a reliable means of diagnosis is required. Precordial contrast echocardiography is usually performed to detect such shunts. To investigate the advantages of transesophageal echocardiographic techniques, we studied 167 consecutive patients with both precordial and transesophageal echocardiography, using two-dimensional imaging with contrast techniques (with and without a Valsalva maneuver) and color flow mapping. A patent foramen ovale was diagnosed in 31 patients, an atrial septal defect in 11 (7 with bidirectional shunts), and a pulmonary arteriovenous fistula in 3 patients. All right-to-left shunts were detected with transesophageal contrast echocardiography. With these results used as the gold standard, the sensitivity of combined precordial techniques was 37% and that of transesophageal color flow mapping 46%. All left-to-right shunts were detected by transesophageal color flow mapping. With these results used as the gold standard, the sensitivities of both precordial color flow mapping and a transesophageal negative right atrial contrast study were 27%. We conclude that transesophageal contrast echocardiography is the echocardiographic method of choice for the detection of a right-to-left shunt at the atrial level, which cannot be excluded by negative results on precordial study or on transesophageal color flow map study. A left-to-right shunt at this level is best detected by transesophageal color flow mapping.
Authors:
M A de Belder; L Tourikis; M Griffith; G Leech; A J Camm
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  124     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-01-12     Completed Date:  1993-01-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1545-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiological Sciences, St. George's Hospital Medical School, Tooting, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Arteriovenous Fistula / ultrasonography*
Echocardiography / methods*
Echocardiography, Doppler
Esophagus
Heart Atria / ultrasonography*
Heart Septal Defects, Atrial / ultrasonography*
Humans
Pulmonary Artery / ultrasonography*
Pulmonary Veins / ultrasonography*
Regional Blood Flow
Sensitivity and Specificity

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


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