Transcranial Doppler Ultrasonography as a Screening Technique for Detection of a Patent Foramen Ovale before Surgery in the Sitting Position

Stendel, Ruediger; Gramm, H.-J.; Schröder, Klaus; Lober, Conny; Brock, M.

doi:10.1097/00000542-200010000-00016

Cited by 98 publications

(49 citation statements)

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“…[1][2][3] Although transesophageal echocardiography is considered the gold standard for RLS across a patent foramen ovale, contrast-enhanced transcranial Doppler is no less sensitive, much better tolerated, and moreover it allows an easier quantification of RLS in a recumbent or a standing position. 4,5 Current recommendations indicate testing in the recumbent position.…”

mentioning

confidence: 99%

Postural Dependency of Right to Left Shunt

Caputi¹,

Carriero²,

Parati³

et al. 2008

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Background and Purpose-Right to left shunt is involved in conditions in which postural changes may be pathogenically relevant. The aim of this work was to assess the frequency of posturally dependent right to left shunt. Methods-In 109 consecutive right to left shunt-positive subjects (male/femaleϭ40/69, age 43Ϯ12 years), we assessed with contrast-enhanced transcranial Doppler the bubble load during normal breathing and after the Valsalva maneuver in both standing and recumbent position randomizing the order of testing. Results-During normal breathing, the average bubble count was 11Ϯ20 in the recumbent and 26Ϯ60 in the standing position. After the Valsalva maneuver, it was 40Ϯ38 and 42Ϯ37, respectively. The increase of bubble load in standing position occurred in 42% of patients and was independent of the order of testing. Conclusions-The amount of permanent right to left shunt is posture-dependent in 40% of patients. Testing in the sitting position may thus be warranted in doubtful or inconclusive results obtained with the subject in the horizontal position.

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confidence: 99%

Postural Dependency of Right to Left Shunt

Caputi¹,

Carriero²,

Parati³

et al. 2008

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“…A recent study reported an incidence of intraoperative venous air embolism of 33% in cases of cervical foraminotomy and of 75% in posterior fossa surgery as detected by contrast enhanced TEE [86]. Should these figures be confirmed, routine preoperative screening for a PFO would appear justified.…”

Section: Pfo and Surgerymentioning

confidence: 99%

Patent foramen ovale: A new disease?

Drighil¹,

Mosalami²,

Elbadaoui³

et al. 2007

International Journal of Cardiology

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“…Neurochirurgische Eingriffe in (halb)sitzender Position haben die höchste Inzidenz venöser Luftembolien. Bei Eingriffen in der hinteren Schädelgrube kommt es in bis zu 75% der Fälle zu teilweise letalen Luftembolien [21,27].Bei abdominellen Operationen wie Lebertransplantationen, Nephrektomien, insbesondere bei laparoskopischen Eingriffen treten Luftembolien gehäuft auf [2,3,4,9]. In der Hüft- [7].…”

Section: Diskussionunclassified