Received:27 April 2017,
Published:30 August 2017
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Wenting WANG, Haiyun HUANG, Qiangwei LIU, et al. Clinical values of transthoracic echocardiography combined with right heart contrast echocardiography in the right-to-left shunt of patent foramen ovale[J]. Journal of Third Military Medical University, 2017, 39(16): 1648-1653.
Wenting WANG, Haiyun HUANG, Qiangwei LIU, et al. Clinical values of transthoracic echocardiography combined with right heart contrast echocardiography in the right-to-left shunt of patent foramen ovale[J]. Journal of Third Military Medical University, 2017, 39(16): 1648-1653. DOI: 10.16016/j.1000-5404.201704145.
Objective
2
To explore the clinical values of transthoracic echocardiography (TTE) combined with right heart contrast echocardiography in the diagnosis of patent foramen ovale (PFO) and to assess the efficacy of transcatheter closure in PFO.
Methods
2
Three hundred and seventy-three patients
including 121 cases with unexplained stroke and 252 cases with migraine
who admitted in the cardiological and neurological departments of our hospital from January 2013 to December 2016
and needed to further diagnose in the presence or absence of PFO
were recruited in this study. All patients underwent TTE and right heart contrast echocardiography
and 103 of them underwent transesophageal echocardiography (TEE) voluntarily.
Results
2
① In the resting state
TTE in 373 patients showed 22 cases with PFO. Next
103 cases of 351 patients with no PFO detected by TTE received TEE
and the results showed 49 patients with PFO. ② All patients also underwent right heart contrast echocardiography when examined with TTE. The results showed that 186 of 373 cases (49.87%) had varying degrees of right-to-left shunt under the condition of Valsalva maneuver or severe cough [69 cases with mild right-to-left shunt (gradeⅠ)
70 cases with moderate shunt(grade Ⅱ) and 47 cases with severe shunt(grade Ⅲ)]. ③ And the examination also showed moderate or severe right-to-left shunts in both 22 cases with PFO confirmed by TTE and 49 cases with PFO confirmed by TEE. ④ Finally
59 patients
having moderate or severe right-to-left shunts confirmed by TTE combined with right heart contrast echocardiography and focal cerebral infarction by MRI
underwent TTE-guided percutaneous transcatheter closure. Right heart contrast echocardiography after 1-month closure operation showed that 55 cases had no right-to-left shunts and 4 cases had mild shunts (grade Ⅰ) under the condition of Valsalva maneuver or severe cough.
Conclusion
2
The combination of TTE and right heart contrast echocardiography could not only show the extent of right-to-left shunt in PFO clearly and provide direct basis for PFO clinical treatment
but also be an effective follow-up method after PFO transcatheter closure. It has been an important tool in PFO diagnosis and follow-up examination after transcatheter closure.
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