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• W38550343 abstract "OBJECTIVE: Correlation of TCD and ICE is poorly described and no data has been shown that describes the anatomic size of the ASD and the degree of TCD shunt, which we aim to reveal in this study. BACKGROUND: Right to left shunts (RLS) found with patent foramen ovale are implicated in the pathophysiology of cryptogenic stroke, migraine headaches as well as decompression illness. Our dysautonomia clinic has studied a syndrome of neurocardiogenic syncope, migraine headaches and positive tilt table testing associated with atrial septal defects (ASD). RLS are typically diagnosed non-invasively using echocardiography ± transcranial Doppler ultrasound (TCD). However, intracardiac echocardiography (ICE) provides a superior image of the cardiac septum. DESIGN/METHODS: We performed a restrospective analysis of a prospectively obtained registry of patients that underwent simultaneous TCD and ICE shunt testing ± endovascular ASD closure. All patients underwent general anesthesia and bilateral TCD monitoring of the middle cerebral artery. Valsalva was manually produced by the anesthesiologist at 40mm Hg. Simultaneous assessment of RLS was performed using ICE and TCD monitoring after injection of agitated saline into the femoral vein sheath. If negative, a direct right atrial injection was performed. The size of ASD was measured by ICE independent of TCD results. RESULTS: Between 9/2010 and 7/2012, 112 patients underwent testing. RLS was found in 81.1 and 71.4 percent by ICE and TCD, respectively. Curtain (too many bubbles to count) TCD shunts had larger physical ASDs compared to non-curtain (2.8mm ± 1.7 vs 1.7mm ± 0.9, p=0.004). Additional cardiac abnormalities, such as Atrial Septal Aneurysm and/or Multifenestrated ASD, had larger ASD sizes compared to those without (3.5mm ± 1.7 vs 1.9 ± 1.3, p=0.0001). CONCLUSIONS: Curtain result on TCD bubble studies is associated with significantly larger ASDs and other cardiac abnormalities in children and young adults. Disclosure: Dr. Doan has nothing to disclose. Dr. Barreto has nothing to disclose. Dr. Fulep has nothing to disclose. Dr. Bui has nothing to disclose. Dr. Butler has nothing to disclose." @default.
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• W38550343 date "2013-02-12" @default.
• W38550343 modified "2023-09-23" @default.
• W38550343 title "Correlation of Atrial Septal Defect Size as Measured by Intracardiac Echocardiography and Transcranial Doppler Ultrasound in Children and Young Adults (P02.102)" @default.
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