Document Detail


Is transesophageal echocardiography still necessary to exclude patent foramen ovale?
MedLine Citation:
PMID:  18569955     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Current guidelines still recommend transesophageal echocardiography (TEE) as reference method to diagnose interatrial shunts. The aim was to test the accuracy of high-end transthoracal echocardiography (TTE) to exclude inter-atrial shunts. METHODS: Prospective TTE and TEE study with second harmonic imaging to determine left-to-right shunt (L/R) by both colour Doppler or R/L by contrast echocardiography in patients with unexplained cerebrovascular incidents or newly detected valvular or myocardial disease. RESULTS: An inter-atrial shunt was diagnosed in 200 of 438 analyzed patients (117 males). Colour Doppler echocardiography visualized a shunt in 67 patients (34%) on TTE vs. 84 (42%) patients on TEE (p <0.0001). However injection of agitated blood with a valsalva maneuver detected 190 (95%) interatrial shunts by both TTE and TEE, but 10 shunts (5%) only by TTE. CONCLUSIONS: Our study shows that patent foramen ovale can safely be demonstrated with high-end transthoracic contrast- echocardiography. If additional studies confirm our results, TTE has the potential to become the method of choice in the diagnosis of PFO.
Authors:
M Zuber; F Cuculi; E Oechslin; P Erne; R Jenni
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  42     ISSN:  1401-7431     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-23     Completed Date:  2008-10-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  222-5     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Kantonsspital Luzern, Luzern, Switzerland. michel.zuber@bluewin.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiomyopathies / physiopathology,  ultrasonography*
Cerebrovascular Disorders / etiology,  physiopathology,  ultrasonography*
Coronary Circulation
Echocardiography, Doppler, Color*
Echocardiography, Transesophageal*
Female
Foramen Ovale, Patent / complications,  physiopathology,  ultrasonography*
Heart Valve Diseases / physiopathology,  ultrasonography*
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Valsalva Maneuver

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


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