Follow-up of residual shunt after patent foramen ovale closure

Orzan F, Liboni W, Bonzano A, Molinari F, Ribezzo M, Rebaudengo N, Grippi G, Negri E. Follow‐up of residual shunt after patent foramen ovale closure.
Acta Neurol Scand: 2010: 122: 257–261.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives –  Transesophageal echocardiogra...

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Published inActa neurologica Scandinavica Vol. 122; no. 4; pp. 257 - 261
Main Authors Orzan, F., Liboni, W., Bonzano, A., Molinari, F., Ribezzo, M., Rebaudengo, N., Grippi, G., Negri, E.
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.10.2010
Blackwell
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Online AccessGet full text
ISSN0001-6314
1600-0404
1600-0404
DOI10.1111/j.1600-0404.2009.01302.x

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Abstract Orzan F, Liboni W, Bonzano A, Molinari F, Ribezzo M, Rebaudengo N, Grippi G, Negri E. Follow‐up of residual shunt after patent foramen ovale closure.
Acta Neurol Scand: 2010: 122: 257–261.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives –  Transesophageal echocardiography (TEE) is usually recommended in the evaluation of the patent foramen ovale (PFO). Our goal is to confirm the efficacy of contrast‐enhanced transcranial Doppler (ce‐TCD) in detecting residual significant right‐to‐left shunts (RLS) after PFO percutaneous closure. Materials and methods –  Sixty‐eight patients with a previous transient ischemic attack, stroke and a large PFO were investigated for residual RLS after percutaneous closure. Results –  Assuming TEE as the gold standard, the sensitivity and negative predictive value of ce‐TCD was 100%, whereas the specificity was 75.8% and the positive predictive value was 28%. Conclusions –  ce‐TCD appears to be the preferable technique to identify subjects with significant residual shunts after percutaneous closure of a PFO. In follow‐up, if ce‐TCD is negative, no further examination may be necessary; whereas if ce‐TCD shows a residual shunt, it is advisable to perform a TEE investigation.
AbstractList Orzan F, Liboni W, Bonzano A, Molinari F, Ribezzo M, Rebaudengo N, Grippi G, Negri E. Follow‐up of residual shunt after patent foramen ovale closure.
Acta Neurol Scand: 2010: 122: 257–261.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives –  Transesophageal echocardiography (TEE) is usually recommended in the evaluation of the patent foramen ovale (PFO). Our goal is to confirm the efficacy of contrast‐enhanced transcranial Doppler (ce‐TCD) in detecting residual significant right‐to‐left shunts (RLS) after PFO percutaneous closure. Materials and methods –  Sixty‐eight patients with a previous transient ischemic attack, stroke and a large PFO were investigated for residual RLS after percutaneous closure. Results –  Assuming TEE as the gold standard, the sensitivity and negative predictive value of ce‐TCD was 100%, whereas the specificity was 75.8% and the positive predictive value was 28%. Conclusions –  ce‐TCD appears to be the preferable technique to identify subjects with significant residual shunts after percutaneous closure of a PFO. In follow‐up, if ce‐TCD is negative, no further examination may be necessary; whereas if ce‐TCD shows a residual shunt, it is advisable to perform a TEE investigation.
Transesophageal echocardiography (TEE) is usually recommended in the evaluation of the patent foramen ovale (PFO). Our goal is to confirm the efficacy of contrast-enhanced transcranial Doppler (ce-TCD) in detecting residual significant right-to-left shunts (RLS) after PFO percutaneous closure. Sixty-eight patients with a previous transient ischemic attack, stroke and a large PFO were investigated for residual RLS after percutaneous closure. Assuming TEE as the gold standard, the sensitivity and negative predictive value of ce-TCD was 100%, whereas the specificity was 75.8% and the positive predictive value was 28%. ce-TCD appears to be the preferable technique to identify subjects with significant residual shunts after percutaneous closure of a PFO. In follow-up, if ce-TCD is negative, no further examination may be necessary; whereas if ce-TCD shows a residual shunt, it is advisable to perform a TEE investigation.
Transesophageal echocardiography (TEE) is usually recommended in the evaluation of the patent foramen ovale (PFO). Our goal is to confirm the efficacy of contrast-enhanced transcranial Doppler (ce-TCD) in detecting residual significant right-to-left shunts (RLS) after PFO percutaneous closure.OBJECTIVESTransesophageal echocardiography (TEE) is usually recommended in the evaluation of the patent foramen ovale (PFO). Our goal is to confirm the efficacy of contrast-enhanced transcranial Doppler (ce-TCD) in detecting residual significant right-to-left shunts (RLS) after PFO percutaneous closure.Sixty-eight patients with a previous transient ischemic attack, stroke and a large PFO were investigated for residual RLS after percutaneous closure.MATERIALS AND METHODSSixty-eight patients with a previous transient ischemic attack, stroke and a large PFO were investigated for residual RLS after percutaneous closure.Assuming TEE as the gold standard, the sensitivity and negative predictive value of ce-TCD was 100%, whereas the specificity was 75.8% and the positive predictive value was 28%.RESULTSAssuming TEE as the gold standard, the sensitivity and negative predictive value of ce-TCD was 100%, whereas the specificity was 75.8% and the positive predictive value was 28%.ce-TCD appears to be the preferable technique to identify subjects with significant residual shunts after percutaneous closure of a PFO. In follow-up, if ce-TCD is negative, no further examination may be necessary; whereas if ce-TCD shows a residual shunt, it is advisable to perform a TEE investigation.CONCLUSIONSce-TCD appears to be the preferable technique to identify subjects with significant residual shunts after percutaneous closure of a PFO. In follow-up, if ce-TCD is negative, no further examination may be necessary; whereas if ce-TCD shows a residual shunt, it is advisable to perform a TEE investigation.
Author Molinari, F.
Negri, E.
Orzan, F.
Liboni, W.
Ribezzo, M.
Bonzano, A.
Grippi, G.
Rebaudengo, N.
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Issue 4
Keywords Sonography
Doppler ultrasound study
Nervous system diseases
Echocardiography
Respiratory disease
Persistent fetal circulation
Cardiovascular disease
transcranial doppler
Congenital disease
Pulmonary hypertension
Newborn diseases
patent foramen ovale
Respiratory failure
Heart disease
transesophageal echocardiography
Ostium secundum
Language English
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Copyright © 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard.
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2002; 39
2004; 44
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1998; 29
2004; 62
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2006; 37
2002; 55
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2003; 16
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1999; 81
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2009; 26
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2000; 35
2006; 27
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2004; 35
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References_xml – reference: Walsh KP, Wilmshurst PT, Morrison WL. Transcatheter closure of patent foramen ovale using the Amplatzer septal occluder to prevent recurrence of neurological decompression illness in divers. Heart 1999;81:257-61.
– reference: Kobayashi K, Igushi Y, Kimura K et al. Contrast transcranial Doppler can diagnose large patent foramen ovale. Cerebrovasc Dis 2009;27:230-4.
– reference: Lock JE. Patent foramen ovale is indicted, but the case hasn't gone to trial. Circulation 2000;101:838.
– reference: Braun MU, Fassbender D, Schoen SP et al. Transcatheter closure of patent foramen ovale in patients with cerebral ischemia. J Am Coll Cardiol 2002;39:2019-25.
– reference: Windecker S, Wahl A, Chatterjee T et al. Percutaneous closure of patent foramen ovale in patients with paradoxical embolism: long-term risk of recurrent thromboembolic events. Circulation 2000;101:893-8.
– reference: Landzberg MJ, Khairy P. Indications for the closure of patent foramen ovale. Heart 2004;90:219-24.
– reference: Sacco RL, Adams R, Albers G et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Circulation 2006;113:e409-49.
– reference: Lechat P, Mas JL, Lascault G et al. Prevalence of patent foramen ovale in patients with stroke. N Engl J Med 1988;318:1148-52.
– reference: Onorato E, Melzi G, Casilli F et al. Patent foramen ovale with paradoxical embolism: mid-term results of transcatheter closure in 256 patients. J Interv Cardiol 2003;16: 43-50.
– reference: Anzola GP, Morandi E, Casilli F, Onorato E. Does transcatheter closure of patent foramen ovale really "shut the door?" A prospective study with transcranial Doppler. Stroke 2004;35:2140-4.
– reference: Pearson AC, Nagelhout D, Castello R, Gomez CR, Labovitz AJ. Atrial septal aneurysm and stroke: a transesophageal echocardiographic study. J Am Coll Cardiol 1991;18:1223-9.
– reference: Anzola GP, Frisoni GB, Morandi E, Casilli F, Onorato E. Shunt-associated migraine responds favorably to atrial septal repair: a case-control study. Stroke 2006;37:430-4.
– reference: Schuchlenz HW. Contrast ultrasound techniques in the detection and quantification of patent foramen ovale: myth versus reality. Stroke 2004;35:2755; author reply, 6.
– reference: Schwerzmann M, Windecker S, Wahl A et al. Implantation of a second closure device in patients with residual shunt after percutaneous closure of patent foramen ovale. Catheter Cardiovasc Interv 2004;63:490-5.
– reference: Spies C, Strasheim R, Timmermanns I, Schraeder R. Patent foramen ovale closure in patients with cryptogenic thrombo-embolic events using the cardia PFO occluder. Eur Heart J 2006;27:365-71.
– reference: Mangiafico S, Scandura S, Ussia GP et al. Transesophageal echocardiography and transcranial color Doppler: independent or complementary diagnostic tests for cardiologists in the detection of patent foramen ovale? J Cardiovasc Med 2009;10:143-8.
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Snippet Orzan F, Liboni W, Bonzano A, Molinari F, Ribezzo M, Rebaudengo N, Grippi G, Negri E. Follow‐up of residual shunt after patent foramen ovale closure.
Acta...
Transesophageal echocardiography (TEE) is usually recommended in the evaluation of the patent foramen ovale (PFO). Our goal is to confirm the efficacy of...
SourceID proquest
pubmed
pascalfrancis
wiley
istex
SourceType Aggregation Database
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Publisher
StartPage 257
SubjectTerms Adult
Biological and medical sciences
Contrast Media
Echocardiography, Transesophageal
Female
Follow-Up Studies
Foramen Ovale, Patent - diagnostic imaging
Foramen Ovale, Patent - surgery
Humans
Ischemic Attack, Transient - diagnostic imaging
Ischemic Attack, Transient - surgery
Male
Medical sciences
Middle Aged
Neurology
patent foramen ovale
Sensitivity and Specificity
Stroke - diagnostic imaging
Stroke - surgery
transcranial doppler
transesophageal echocardiography
Treatment Outcome
Ultrasonography, Doppler, Transcranial - methods
Title Follow-up of residual shunt after patent foramen ovale closure
URI https://api.istex.fr/ark:/67375/WNG-654NZMLX-T/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1600-0404.2009.01302.x
https://www.ncbi.nlm.nih.gov/pubmed/19951266
https://www.proquest.com/docview/799791824
Volume 122
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