Echocardiographic Evaluation of Patent Foramen Ovale and Atrial Septal Defect

Abstract

Patent foramen ovale (PFO) is a common variant present in up to 25% of the population. Atrial septal defect (ASD) is a direct communication between the 2 atrial chambers, of which the ostium secundum variety is the most common. This manuscript is an in depth review of the complex atrial septation, the diagnosis of PFO and ASD and its clinical and therapeutic implications.

When to use femoral vein injection for diagnosis of patent foramen ovale—Effect of a persistent eustachian valve on right atrial flow patterns during contrast transesophageal echocardiography

“…Patent foramen ovale (PFO) is present in a significant proportion of the general population, and in the majority of subjects, it is not associated with any sequelae. Its prevalence is estimated to be 25% of the population . In a proportion of subjects, a right‐to‐left shunt through a PFO is associated with clinical conditions including cryptogenic stroke, decompression sickness, migraine, and platypnea‐orthodeoxia syndrome.…”

“…Contrast echocardiography using transesophageal echocardiography is regarded as the gold standard modality for the diagnosis of patent foramen ovale. It is well recognized that false‐negative results can occur even if a standardized protocol is employed . Recognition of factors that might cause a false‐negative result is important because specific measures can be undertaken to avoid such confounding factors .…”

Cardiac CT and MRI for Assessment of Cardioembolic Stroke

“…The association between PFO and cryptogenic stokes has been well established [32]. It is frequently considered as a possible cardioembolic source since it allows for potential paradoxical embolism, a systemic arterial embolus from a venous source [3].…”

Patent Foramen Ovale and Atrial Septal Defect: Utility of Alternative Imaging Modalities for the Diagnosis of Patent Foramen Ovale and Atrial Septal Defect

“…We read with interest the article "Patent Foramen Ovale (PFO) and Atrial Septal Defect (ASD)" by Hari et al 1 The article is a review describing the anatomy and embryology of the atrial septum and the diagnosis of PFO and ASD using echocardiography. The authors mention the importance of transesophageal echocardiography (TEE) in visualizing the atrial septal anatomy, measuring the degree of right-to-left shunting (RLS), and determining the type and size of the closure device preprocedure.…”