title: Contrast echocardiography and transcranial Doppler sonography for detection of a patent foramen ovale.
abstract: We report the case of a patient, in whom a patent foramen ovale was detected. For the detection of a patent foramen ovale simulation of Valsalva's manoeuvre with a positive airway pressure of 20 cm H2O was applied. Change of ventilation manoeuvre by ventilation with positive airway pressure of 35/30/15 cm H2O at a tidal volume of 1200 ml make a distinct increase in passage of contrast medium from the right to the left atrium. These findings were detected by contrast transesophageal echocardiography and indirectly by transcranial Doppler sonography and were reproducible. This may stress the importance of preoperative screening of patent foramen ovale in patients to be operated on in the sitting position. Contrast echocardiography and the ventilatory manoeuvre with high airway pressure and PEEP might increase the detection rate of patent foramen ovale with a right to left shunt during general anaesthesia.
authors.affiliation: Department of Anaesthesiology, Medical School University of Ioannina Greece B Franklin Hospital Free University of Berlin, Germany.
authors.forename: G S
authors.initials: GS
authors.lastname: Papadopoulos
authors.forename: A
authors.initials: A
authors.lastname: Zauner
authors.forename: M
authors.initials: M
authors.lastname: Brock
mesh_terms: D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D017585:Ultrasonography, Doppler, Transcranial