Differential diagnosis between patent foramen ovale and pulmonary arteriovenous fistula in two patients with previous cryptogenic stroke caused by presumed paradoxical embolism
“…They cause cyanosis and in some instances embolic accidents. 22 Acquired fistulae such as those observed at long term follow up after a surgically created cavopulmonary shunt are mostly small and multiple. All kinds of devices, and especially coils, can be used.…”
“…They cause cyanosis and in some instances embolic accidents. 22 Acquired fistulae such as those observed at long term follow up after a surgically created cavopulmonary shunt are mostly small and multiple. All kinds of devices, and especially coils, can be used.…”
“…The technique involves injection of echo contrast into a peripheral vein. The appearance of bubbles in the left atrium confirms right-to-left shunting and if they can be seen entering the left atrium via a single pulmonary vein, contrast echocardiography confirms the exact anatomic localization of the fistula [2]. For this reason it is always necessary to monitor the pulmonary veins during injection of the contrast by TEE.…”
Section: Discussionmentioning
confidence: 87%
“…Contrast echocardiography [2] hereby is an extremely useful tool for diagnosis. The technique involves injection of echo contrast into a peripheral vein.…”
“…Noncardiac sources of RLS such as PAVM have been associated with cerebrovascular events (16,17), and the presence of multiple PAVMs significantly increases the risk of cerebrovascular events (odds ratio: 4.5; 95% CI: 1.47 to 14) (18). Published case reports have documented the coexistence of noncardiac source of RLS with PFO (19,20); however, large case series are lacking in the literature.…”
This is the first report to systematically assess the prevalence of secondary RLS in patients undergoing PFO closure. Residual RLS detected by TCD may be due to secondary RLS, which may have implications for clinical outcomes.
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