The application value of foam test and transesophageal ultrasonography in the diagnosis and treatment of patent foramen ovale
Objective To explore the clinical value of TTE,CTTE,c-TCD and TEE in guiding PFO interventional occlusion.Methods The relevant data of 68 patients suspected of PFO receiving the above examination were collected.Results Among the 65 patients initially diagnosed with PFO by TTE,7 cases(10.7％)were eliminated PFO by Tee,and 3(4.4％)patients with a history of migraine or stroke who were excluded PFO by TTE but were confirmed by Tee.61 patients underwent quantitative transseptal shunt combined with TTE and c-TCD,RLS=Grade Ⅰ in 5 patients(8.2％),RLS=Grade Ⅱ in 5 patients(8.2％),RLS≥ Grade Ⅲin 51 patients(83.6％),and 51 patients with RLS ≥ 111 underwent transcatheter interventional closure successfully.The positive rate of CTTE plus Valsalva was higher than that of resting state(72.1％VS44.3％,P＜0.05).The positive rate of C-TCD plus Valsalva was also higher than that of resting state(85.2％VS 49.1％,P＜0.05).The overall detection rate of RLS ≥ Ⅲ was similar between TTE and c-TCD(72.1％VS 85.2％,P＞0.05).The detection rate of RLS ≥Ⅲ was higher in combination of TTE and c-TCD than that in any of these methods alone(100％VS 72.1％VS 85.2％,all P＜0.05).Conclusions Because of the existence of false negative and false positive,TTE can only be used as a primary screening method for PFO.The combined application of CTTE and c-TCD can make qualitative and quantitive of transseptal shunt in patients with PFO,and it is an important means to judge the indication of transcatheter closure.TEE can provide three-dimensional shape and adjacent structure information of PFO,guide the choice of occluder,improve the success rate of surgery and reduce complications.The combined application of the three methods has important clinical value in the diagnosis of PFO and the preoperative decision-making of interventional occlusion.
万方数据
维普
