Clinical value of right heart echocardiography in judging right-to-left shunt of patent foramen ovale

Objective To compare thecontrast transcranial dopple(cTCD), contrast transthoracic echocardiography(cTTE) and contrast transthoracic combined with transesophageal echocardiography (cTEE) to diagnose the patent foramen ovale. Methods 120 cases of migraine patients caused by other reasons were excluded from our hospital. The three methods of cTCD, cTTE, and cTEE were observed. Whether there is a right-to-left shunt and a semi-quantitative grading of the number of microbubbles, and then comparing the three methods with intraoperative and postoperative data. Results In the diagnosis of patent foramen ovale (PFO), the sensitivity, specificity, and diagnostic rate of cTTE were higher than those of cTCD. The detection rate of cTEE was higher than cTTE, and patients with moderate or higher right-to-left shunt and MRI confirmed cerebral infarction were successfully treated with PFO blocking surgery under the guidance of TTE. 1 month after surgery, cTTE showed that 50 cases of right-to-left shunt disappeared in Valsalva and severe cough, and 3 cases still had a small amount of right-to-left shunt.Conclusion cTTE is simple, safe and reliable. It has significant advantages in the diagnosis of unexplained migraine diseases and has high clinical value. cTTE can not only clearly show the existence of right-to-left shunt of PFO, but also determine the degree of right-to-left shunt, which provides a direct basis for clinical treatment of PFO. It can also be used as an important tool for clinical follow-up after PFO closure.