[Do results of transoesophageal echocardiography during closure of patent foramen ovale influence interventional therapy?].
OBJECTIVE
The aim of the present study was to characterise the morphology of patent foramen ovale (PFO) by a standardised protocol during transoesophageal echocardiography and to estimate the final and successful position of PFO-occluding devices (PFO-Star) by evaluation of parameters determined by echocardiography. The echoacardiographic parameters of septum- and PFO-morphology determined before the intervention were analysed with regard to choosing the optimal device-system for transcatheter PFO-closure.


METHODS
Transoesophageal echocardiography combined with application of contrast-media was performed in 31 patients before, during and after PFO-closure by using the PFO-Star-Device. The pre-interventional morphological parameters were compared with the result after PFO-closure.


RESULTS
Quantitative contrast-bubble-shunting, PFO-channel-length and Vena contracta detected by colour flow Doppler do not show any correlation. PFO-channel-length in cases with small angles between aorta and septum seems to be associated with higher risk of clinically irrelevant device-shift as well as residual shunt.


CONCLUSIONS
A standardised procedure in transoesophageal echocardiography is suitable for characterising the morphology of PFO. Neither the morphology in 2D-imaging nor the amount of shunt microbubble seen in the left atrium allows a conclusive statement about the PFO size. For obtaining an optimal closure result, it is important to identify the channel-length and the distance between the interatrial septum and the PFO together with the angles between septum and the surrounding intracardiac structures.
Medizinische Klinik der Universität Leipzig, Abteilung Kardiologie/Angiologie, Leipzig.
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Jurisch
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Hagendorff
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Pfeiffer
D000293:Adolescent; D000328:Adult; D000368:Aged; D017548:Echocardiography, Transesophageal; D005260:Female; D054085:Foramen Ovale / Q000000981:diagnostic imaging; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016216:Ultrasonography, Prenatal; D055815:Young Adult