Is the patent foramen ovale closure the best option?

Zétola, Viviane Flumignan; Silva, Melissa Castello Branco e; Lange, Marcos Christiano; Muzzio, Juliano André; Nóvak, Edison Matos; Moraes, Admar; Werneck, Lineü Cesar

doi:10.1590/s0004-282x2012001200006

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…Similar to cTTE, activated saline and VM were needed for this test. The VM was considered effective when there is a 25% decrease of MCA flow velocity (Zetola et al., ). The modified quantification criteria used were based on the Consensus Conference of Venice (Serena et al, ).…”

Section: Methodsmentioning

confidence: 99%

A comparison of contrast transthoracic echocardiography and contrast transcranial Doppler in cryptogenic stroke patients with patent foramen ovale

Chen

et al. 2019

Brain and Behavior

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Objective In recent years, increasing attention has been paid to cryptogenic stroke (CS) caused by the patent foramen ovale (PFO). This study aims to compare contrast transthoracic echocardiography (cTTE) and contrast transcranial Doppler (cTCD) to determine whether cTTE is more suitable and reliable than cTCD for clinical use. Methods From March 2017 to May 2018, patients who suffered from migraines, stroke, hypomnesis, or asymptomatic stroke found casually were included in our study. Patients with CS were semirandomly divided into two groups (cTTE and cTCD) according to the date of the outpatient visit. Patients with either of the examination above found positive were selected to finish transesophageal echocardiography (TEE). Results In our study, the sensitivities of group cTTE positive (group cTTE+) and group cTCD positive (group cTCD+) did not have any statistical difference (89% vs. 80%, p = 0.236). Focusing on group cTCD+, we discovered that the semiquantitative shunt grading was not correlated with whether a PFO was present or not ( p = 0.194). However, once the PFO has been diagnosed, the shunt grading was shown to be related to the width of the gaps ( p = 0.032, p deviation = 0.03). Conclusion Both cTTE and the cTCD can be used for preliminary PFO findings. The semiquantitative shunt grading of cTCD and cTTE can suggest the size of the PFO and the next course of treatment. The cTTE may be more significant to a safe PFO (a PFO does not have right‐to‐left shunts, RLSs). Combining cTTE and TEE could help diagnose PFO and assess CS risk.

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Section: Methodsmentioning

confidence: 99%

A comparison of contrast transthoracic echocardiography and contrast transcranial Doppler in cryptogenic stroke patients with patent foramen ovale

Chen

et al. 2019

Brain and Behavior

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“…A previous study from the same service evaluated 20 patients after surgical occlusion of the PFO and concluded that most of them would still have passage of a residual MES 01 year after occlusion. 20 Some advantages of TCD include the facts that it is a non-costly, non-invasive, and repeatable examination. 21 Since it is non-invasive, the exam can be performed without sedation, which allows for patient cooperation during the Valsalva maneuver.…”

Section: Discussionmentioning

confidence: 99%

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2023

JNSK

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Introduction: Patent foramen ovale (PFO) is an interatrial embryonic remnant that results in right-to-left (RLC) circulation communication, therefore associated with paradoxical embolic events. PFO is associated with cases of stroke of undetermined origin in young people, although it is present in approximately 30% of the general population and its incidental finding in complementary exams is common. The causal relationship has been explored in many published studies, and the search for high-risk markers has been the subject of numerous meta-analyses. Transcranial contrast Doppler (cTCD) is considered the screening test of choice because it is a low-cost, non-invasive diagnostic tool with high sensitivity and specificity. The exam considered the gold standard is the transesophageal echocardiogram (TEE). Methods: The database of the Neurosonology Laboratory of a University Hospital was used, reviewing information from 901 patients from January 2015 to May 2019. From this total (901), 217 patients who had undergone cTCD and TEE were included. The functional pattern by cTCD followed criteria previously published in the Latin American Consensus. Results: The assessment of the subgroup that had the cTCD and ETE performed, we found high sensitivity and specificity of cTCD when compared to the gold standard exam. Conclusion: Comparison of diagnostic tests for RLC resulted in a sensitivity of 95.9% and a specificity of 91.3%, with a PPV of 95.9% and a NPV of 91.3%.

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“…Inicialmente, eram utilizados dispositivos semelhantes aos de correção de comunicação interatrial e atualmente são usados dispositivos criados especificamente para fechamento do FOP. Além disso, o procedimento apresenta baixa morbi-mortalidade e uma alta taxa de sucesso 14,15 .…”

Section: Discussionunclassified

Acidente vascular cerebral isquêmico em paciente portador de forame oval patente: relato de caso

et al. 2019

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O forame oval representa uma comunicação entre as câmaras cardíacas atriais do feto e este se fecha ao nascimento. Em algumas pessoas, no entanto, o mesmo permanece pérvio e favorece o desenvolvimento de acidente vascular isquêmico (AVE) criptogênico. Cabe salientar que a isquemia cerebral de causa desconhecida pode ocorrer em pacientes jovens e que não possuem fatores de risco, por isso é de extrema relevância que o forame oval patente seja incluído como hipótese etiológica, a fim de que o tratamento adequado seja instituído. O objetivo do artigo é relatar o caso de um paciente portador de forame oval patente que evoluiu com AVE isquêmico, correlacionando achados clínicos, métodos diagnósticos e conduta com dados da literatura. Paciente C.F.S., sexo masculino, 53 anos, sem comorbidades, apresentou déficit na acuidade visual associado à escotomas cintilantes bilateralmente e cefaleia bitemporal em aperto enquanto realizava atividades domésticas de baixo esforço. Foi admitido em setor de emergência e após a avaliação inicial, realizou-se ressonância magnética de crânio que comprovou AVE isquêmico. A ecocardiografia transesofágica confirmou o diagnóstico de forame oval patente. A conduta estabelecida foi o fechamento percutâneo transcateter eletivo com dispositivo de oclusão do forame oval. É de suma importância o avanço dos estudos do AVE criptogênico, uma vez que o manejo adequado pode interferir na sobrevida e qualidade de vida do paciente, ao evitar a progressão de sequelas ou um novo evento.

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Is the patent foramen ovale closure the best option?

Cited by 4 publications

References 20 publications

A comparison of contrast transthoracic echocardiography and contrast transcranial Doppler in cryptogenic stroke patients with patent foramen ovale

A comparison of contrast transthoracic echocardiography and contrast transcranial Doppler in cryptogenic stroke patients with patent foramen ovale

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Acidente vascular cerebral isquêmico em paciente portador de forame oval patente: relato de caso

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