title: Follow-up of residual shunt after patent foramen ovale closure.
abstract: OBJECTIVE
  Transesophageal echocardiography (TEE) is usually recommended in the evaluation of the patent foramen ovale (PFO). Our goal is to confirm the efficacy of contrast-enhanced transcranial Doppler (ce-TCD) in detecting residual significant right-to-left shunts (RLS) after PFO percutaneous closure.
  
  
  METHODS
  Sixty-eight patients with a previous transient ischemic attack, stroke and a large PFO were investigated for residual RLS after percutaneous closure.
  
  
  RESULTS
  Assuming TEE as the gold standard, the sensitivity and negative predictive value of ce-TCD was 100%, whereas the specificity was 75.8% and the positive predictive value was 28%.
  
  
  CONCLUSIONS
  ce-TCD appears to be the preferable technique to identify subjects with significant residual shunts after percutaneous closure of a PFO. In follow-up, if ce-TCD is negative, no further examination may be necessary; whereas if ce-TCD shows a residual shunt, it is advisable to perform a TEE investigation.
authors: Department of Internal Medicine - Cardiology, University of Torino, Torino, Italy.
authors: F
authors: F
authors: Orzan
authors: W
authors: W
authors: Liboni
authors: A
authors: A
authors: Bonzano
authors: F
authors: F
authors: Molinari
authors: M
authors: M
authors: Ribezzo
authors: N
authors: N
authors: Rebaudengo
authors: G
authors: G
authors: Grippi
authors: E
authors: E
authors: Negri
mesh_terms: D000328:Adult; D003287:Contrast Media; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
chemical_list: D003287:Contrast Media