Timing of transesophageal echocardiography in diagnosing patent foramen ovale in patients supported with left ventricular assist device.
Left ventricular assist devices unload the left ventricle and decrease left atrial pressure. This hemodynamic change may cause a right to left atrial shunt and hypoxemia in patients with patent foramen ovale. We prospectively studied the best time for performing diagnostic transesophageal echocardiography in left ventricular assist device patients. Intraoperative transesophageal echocardiography was performed in 14 patients before cardiopulmonary bypass was initiated and after left ventricular assist device was implanted. No patent foramen ovale was detected when transesophageal echocardiography was done before bypass, but a patent foramen ovale was found in 3 patients when transesophageal echocardiography was performed after left ventricular assist device was activated. Patent foramen ovale was confirmed by inspection in all three patients and surgically closed during the same procedure. There were no patent foramen ovale closure-related complications.
Division of Cardiovascular and Thoracic Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA. liaox014@umn.edu
Kenneth K
KK
Liao
Leslie
L
Miller
Cynthia
C
Toher
Sophia
S
Ormaza
Cynthia S
CS
Herrington
Hartmuth B
HB
Bittner
Soon J
SJ
Park
D006348:Cardiac Surgical Procedures; D017548:Echocardiography, Transesophageal; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D007432:Intraoperative Period; D011446:Prospective Studies; D013997:Time Factors