ArticleOpen heart2020
Echocardiographic diagnosis of right-to-left shunt using transoesophageal and transthoracic echocardiography.
Article in Open heart, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Nurse-led preprocedural Valsalva maneuver training with a maximal expiratory pressure device during transesophageal echocardiography in South Korea: a quasi-experimental study.Journal of Korean biological nursing science · 2026Article
- The helpful support of veno-arterial extracorporeal membrane oxygenation to treat an exceptional systemic-to-pulmonary venous shunt: A case report.Physiological reports · 2026Article
- Incremental value of characteristics of right-to-left shunt in patients with migraine and cryptogenic stroke via multi-modal echocardiography.Quantitative imaging in medicine and surgery · 2026Article
- Subclinical Brain Lesions in Magnetic Resonance Imaging are a Potential Indicator of Patent Foramen Ovale Related Migraines in Younger Patients.Reviews in cardiovascular medicine · 2025Article
- Hemodynamic Monitoring During Liver Transplantation for Patients on Perioperative Extracorporeal Membrane Oxygenation (ECMO) Support: A Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
- Intracardiac Shunts Among Patients Undergoing Oil-Based Contrast Lymphangiography: Prevalence and Rate of Systemic Arterial Embolic Complications.Mayo Clinic proceedings. Innovations, quality & outcomes · 2024Article
- A patient with unexplained hypoxemia after a fall diagnosed with platypnea orthodeoxia syndrome: approaches to resolving discrepancies between level of hypoxemia and clinical presentation.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Article
- Diagnostic value of contrast-enhanced ultrasonography for patent foramen ovale detection.Journal of thoracic disease · 2024Article
- Unresponsiveness to Chiari Malformation Type I Surgery Can Be Related to the Accompanying Chiari Network.Cureus · 2024Article
- A Case of Reverse McConnell's Sign Associated With Acute Respiratory Distress Syndrome and Septic Shock.Cureus · 2024Article
- Pulmonary arteriovenous fistula in a rare location: The importance of excluding patent foramen ovale.Journal of cardiology cases · 2023Article
- Why Living with Pulmonary Arterial Hypertension Requires a Holistic Approach: A Patient and Clinician Perspective.Pulmonary therapy · 2023Article
- Recent progress in patent foramen ovale and related neurological diseases: A narrative review.Frontiers in neurology · 2023Review
- Patent Foramen Ovale and Ascending Aortic Dilatation Causing Platypnea-Orthodeoxia Syndrome.Cureus · 2022Article
- Detecting Patent Foramen Ovale after Cryptogenic Stroke - A Single Center Experience in Taiwan.Acta Cardiologica Sinica · 2022Article
- The Value of Contrast-Enhanced Transesophageal Echocardiography in the Detection of Cardiac Right-to-Left Shunt Related with Cryptogenic Stroke and Migraine.BioMed research international · 2020Article
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2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe diagnosis and quantification of right-to-left shunt (RLS) using transthoracic echocardiography (TTE) as well as transoesophageal echocardiography (TOE) have not been well established. We aimed to diagnose RLS by TOE using direct visualisation of the shunt and to compare the diagnosis with TTE diagnosis using conventional methods. METHODS AND
resultsWe evaluated 141 patients with ischaemic stroke for RLS by both non-sedation TOE and TTE using saline contrast and Valsalva manoeuvre. The amount (graded as 0 to IV) and timing of RLS were demonstrated. All patients were classified into four groups by TOE based on direct visualisation of shunt through a patent foramen ovale (PFO) or either pulmonary vein: no shunt (group 1: n=11), PFO (group 2: n=47), pulmonary RLS (group 3: n=25) and indeterminate RLS (group 4: n=58). All cases in group 3 showed delayed shunt, and all cases in group 4 had small shunt. On TTE findings, all cases with early appearing large shunt (cardiac cycles ≤3 and shunt grade ≥III) were group 2. Six of the eight patients with delayed appearing large shunt on TTE were group 3. TTE diagnosis of PFO using criteria of cardiac beats ≤3 and grade ≥II had a sensitivity of 85% and a specificity of 98% compared with TOE diagnosis using shunt visualisation.
conclusionsCompared with TOE using shunt visualisation, TTE accurately diagnosed large PFO using criteria of cardiac cycles ≤3 and shunt grade ≥III. TTE possibly diagnosed pulmonary shunt using criteria of cardiac cycles >3 and shunt grade ≥III. Both modalities showed limitations in diagnosing small amount of RLS.
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