Echocardiographic Guidance of Percutaneous Patent Foramen Ovale Closure: Head‐to‐Head Comparison of Transesophageal versus Rotational Intracardiac Echocardiography

Abstract

Our study suggests a significant disagreement between TEE and rotational ICE in measuring fossa ovalis and selecting the device for PFO closure, particularly in patients with ASA.

Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions

“…52,61,63,[68][69][70][71][72][73][74][75] Contrast echocardiography and contrast TCD is discussed further in sections on Assessment of Shunting; Techniques, Standards, and Characterization Visualization of Shunting: TTE and TEE; and Transcranial Doppler Detection/Grading of Shunting. Table 1 summarizes the recommended general imaging approach to atrial septal abnormalities stratified by the patient characteristics, imaging modality, and intended application (e.g., diagnosis, procedure selection or guidance, follow-up).…”

Three‐Dimensional Echocardiographic Assessment of Patent Foramen Ovale in Platypnea‐Orthodeoxia

“…Patients with complicated anatomy including fenestrated ASD also benefit from RT3DTEE . Intra‐cardiac echocardiography also carries similar advantages, but it is unclear which imaging modality is superior, especially in cases with ASA …”

“…5,6,8 Intra-cardiac echocardiography also carries similar advantages, but it is unclear which imaging modality is superior, especially in cases with ASA. 9 Although unclear, several theories have been proposed to explain right-to-left shunting in patients with long standing PFO including right hemidiaphragmatic elevation and progressively worsening compliance of the right ventricle. 10 This patient had right hemidiaphragmatic elevation likely leading to a stretched PFO and increased shunt.…”

Echocardiography in the Era of Multimodality Cardiovascular Imaging

“…Its biggest advantage over TOE is the ability to obtain similar echo views without the need for general anaesthesia, with its attendant costs and potential risks. Therefore, ICE has been used in preference to TOE for a number of procedures, including atrial fibrillation [67] and ventricular tachycardia [68] ablation procedures, closure of septal defects [69], TAVI procedures [70] and to guide CRT procedures [71]. However, the significant limitation of ICE is expensive, given that the probes must be disposed of after a single use.…”