A new definition in the patent foramen ovale

Therefore, for avoiding possible limitations it may be helpful to focus on the junction between the septum primum and secundum to interrogate for the presence of PFO.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: The aim of this study is to identify the prevalence of PFO, which definition based on the detection of the seperation between septum primum and secundum by transesophageal echocardiography (TEE), and to seek the relationship between atrial functions and contrast passage.

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Key Findings & Data:TEE were performed with a Hewlett-Packard (Sonos 1500) 5 MHz multiplane transducer.

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Conclusion & Impact:Therefore, for avoiding possible limitations it may be helpful to focus on the junction between the septum primum and secundum to interrogate for the presence of PFO.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Tanı teknikleri · kalp damar · Kalp septal defektleri

Abstract

Aim: The aim of this study is to identify the prevalence of PFO, which definition based on the detection of the seperation between septum primum and secundum by transesophageal echocardiography (TEE), and to seek the relationship between atrial functions and contrast passage. Material and Methods: Two hundred two consecutive patients referred for TEE were studied. TEE were performed with a Hewlett-Packard (Sonos 1500) 5 MHz multiplane transducer. The transducer was positioned to give a clear view of the thinnest portion of the interatrial septum and the junction between the septum primum and secundum to interrogate for the presence of PFO. Differentiating septum primum and secundum and visualising the tunnel, which is formed by these two septums, was the main criteria to define PFO. Results: The patients with no contrast passage had greater heart rate (91±15 vs. 79±14 beat/min, p=0.002), left ventricular diastolic diameter (3.54±0.82 vs 3.1±0.62, p=0.02) and rate of atrial fibrillation (%55 vs.%30, p=0.034) while left ventricular ejection fractıon was lower (.56.±12 vs 64±8, p=0.004.) than those with contrast passage. Besides, left atrial diameter (4.96±0.85 vs. 3.95.±0.69, p<0.001), area (27±8.3 vs.18.4±6.4, p<0.001) and spontaneous echo contrast degree were also greater (1.61±1.37 vs. 0.38±0.81, p<0.001) while left atrial appendage ejection rate was lower in patients with no contrast passage. (42±23 vs. 68±24, p<0.001). Conclusion: It is likely that a deterioration in left atrial function may prevent the contrast passage from right to left. Therefore, for avoiding possible limitations it may be helpful to focus on the junction between the septum primum and secundum to interrogate for the presence of PFO.

Özet

Amaç: Patent foramen ovale (PFO) tanısı koyarken mevcut kısıtlamalardan etkilenmemek için TEE ile septum primum ve sekundum ayrışmasınının görülmesini esas alarak, PFO sıklığını ve PFO varlığında kontrast geçişi ile her iki atriyum fonksiyonu arasındaki ilişkiyi araştırmak için bu çalışmayı planladık. Gereç ve Yöntem: Çalışmaya değişik endikasyonlar sebebiyle TEE incelemesi istenen arka arkaya 202 hasta dahil edildi. Bütün incelemeler Hewlett-Packard Sonos 1500 ekokardiyografi cihazına takılan multiplane 5 MHz TEE probu yardımıyla gerçekleştirildi. Septumun en ince yerini lokalize etmek ve PFO tanısı için septum primum ile sekundumun birleşme yerini en iyi görmek için gerekli olan kesit bulundu. Septum primum ve sekundumun ayırt edilebilmesi ve atriyumların her iki septumun oluşturduğu tünelle birbiri ile bağlantısının saptanması PFO tanısı için esas alındı. Bulgular: Sol atriyuma kontrast geçişi görülmeyen grupta kalp hızı (91±15 karşı 79±14 atım/dak, p=0.002), sol ventrikül sistolik çapı (3.54±0.82 karşı 3.1±0.62, p=0.02) ve atriyal fibrilasyon görülme sıklığı kontrast geçişi saptanan gruba göre daha fazla iken (%55 karşı %30, p=0.034) sol ventrikül ejeksiyon fraksiyonu düşüktü (56±12 karşı 64±8, p=0.004) (Tablo 1). Kontrast geçişi görülmeyen grupta sol atriyum çapı (4.96±0.85 karşı 3.95.±0.69, p<0.001), alanı (27±8.3 karşı18.4±6.4, p<0.001) ve spontan eko kontrast derecesi daha fazla iken (1.61±1.37 karşı 0.38±0.81, p<0.001) sol atriyum apendiks boşalma hızı daha düşüktü (42±23 karşı 68±24, p<0.001). Sonuç: PFO da sol atriyuma kontrast geçişini esas olarak sol atriyum fonksiyonu belirler. Bu yüzden PFO tanısı için sol atriyuma kontrast geçişinden ziyade septum sekundum ve primum ayrışmasını almak daha uygun olabilir.

Keywords

Tanı teknikleri kalp damar Kalp septal defektleri atrial Ekokardiyografi transözefageal Kalp atriumu Diagnostic Techniques Cardiovascular Heart Septal Defects Atrial Echocardiography Transesophageal Heart Atrium

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Cite This Article

GÖRGÜLÜ, Ş., EREN, M., ÇELİK, S., YILDIRIM, A., USLU, N., DAĞDEVİREN, B., GÜROL, T., UZUNLAR, B., NURKALEM, Z., TEZEL, T. (2003). A new definition in the patent foramen ovale. MN Kardiyoloji, Cilt: 10 - Sayı: 2, 104–110. https://ajindex.com/articles/297811

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