Transcatheter patent foramen ovale closure versus standard medical therapy for prevention of recurrent stroke: Updated Meta-analysis with an importance on shunt size

Patel, Krunalkumar; Doshi, Rajkumar; Goyal, Hemant; Shah, Priyank; Meraj, Perwaiz

doi:10.1016/j.ejim.2018.08.009

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…These findings add to the current body of evidence indicating a potential association between the PFO size and the risk of paradoxical embolic stroke 3 .…”

supporting

confidence: 72%

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The quest for the identification of pathogenic patent foramen ovale

Ameriso

2021

Arq. Neuro-Psiquiatr.

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“…These findings add to the current body of evidence indicating a potential association between the PFO size and the risk of paradoxical embolic stroke 3 .…”

supporting

confidence: 72%

“…Numerous reports have established an important role of size and other anatomical characteristics of the PFO that may increase the likelihood of causing strokes 3 .…”

mentioning

confidence: 99%

The quest for the identification of pathogenic patent foramen ovale

Ameriso

2021

Arq. Neuro-Psiquiatr.

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“…It is important to note that the risk reduction was dependent on the shunt size, especially in those with moderate-tolarge shunts, and patients with small shunts did not appear to benefit from PFO closure. Hence, shunt size should be considered when evaluating patients for potential PFO closure for the prevention of recurrent stroke [28]. In this study, when the VM was adequate, the higher the PFO RLS grade was judged, it was mostly RLS grade 3, while the invalid or insufficient VM judged the RLS classification to be grade 1 or false negatives.…”

Section: Discussionmentioning

confidence: 81%

Aortic Root Downward Movement as a Novel Method for Identification of an Adequately Performed Valsalva Maneuver to Detect Patent Foramen Ovale during Transesophageal Echocardiography

et al. 2022

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The Valsalva maneuver (VM) is the most sensitive auxiliary method for the detection of patent foramen ovale (PFO), but it is difficult to assess whether the maneuver is adequately performed during transesophageal echocardiography (TEE). In this study, we tried to use aortic root downward movement as a novel method for judging whether VM was adequate or not, and to evaluate whether this novel method can increase the sensitivity of detecting PFO. A total of 224 patients with clinically suspected PFO were enrolled in this study. These patients were injected with activated normal saline to detect the right-to-left shunt (RLS), in the following three conditions: contrast-enhanced transthoracic echocardiography under adequate VM (AVM cTTE), contrast-enhanced TEE under non-adequate VM (non-AVM cTEE), and cTEE under adequate VM (AVM cTEE). A novel method in which the aorta root moves downward (movement range ≥16 mm) in the cTEE judged whether AVM was performed. The PFO detection rate and sensitivity of AVM cTEE were better than that of non-AVM cTEE (detection rate: 108 PFOs [48.2%] vs. 86 PFOs [38.4%], p = 0.036; sensitivity: 100% vs. 79.6%). Among AVM cTTE, non-AVM cTEE, and AVM cTEE, the RLS grade evaluation results were inconsistent, with significant differences (p < 0.05). Non-AVM cTEE had RLS underestimation or false negatives. Compared with non-AVM cTEE, AVM cTEE and AVM cTTE had better consistency in evaluating PFO RLS (kappa value = 0.675). Aortic root downward movement could be used as a novel method for judging the effectiveness of VM, which is critical for the detection of PFO in cTEE. Concerning effectiveness and convenience, this method should be promoted during the clinical detection of PFO.

show abstract

Transcatheter patent foramen ovale closure versus standard medical therapy for prevention of recurrent stroke: Updated Meta-analysis with an importance on shunt size

Cited by 2 publications

References 10 publications

The quest for the identification of pathogenic patent foramen ovale

The quest for the identification of pathogenic patent foramen ovale

Aortic Root Downward Movement as a Novel Method for Identification of an Adequately Performed Valsalva Maneuver to Detect Patent Foramen Ovale during Transesophageal Echocardiography

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