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At least 1,225 records · Page 68Linked to original sources
PubMed2001

Cerebral infarction in conjunction with patent foramen ovale and May-Thurner syndrome.

Stroke patients with paradoxical embolus mandate a search for deep venous thrombosis (DVT) in the lower extremities. Iliac vein compression, or May-Thumer syndrome, places certain patients at risk for development of DVT. The authors present 3 stroke patients with patient foramen ovale and paradoxical cerebral embolism, with demonstrated iliac vein compression as the presumed source of their embolus. May-Thumer syndrome should be considered a potential source of clot, as definitive therapy of this disorder can be curative.

Adult↗
PubMed1998

Dye dilution and oximetry for detection of patent foramen ovale.

OBJECTIVES: Patent foramen ovale (PFO) is a risk factor for stroke of undetermined (cryptogenic) origin. Low cost and non-invasive bedside tests for detection of PFO are needed as alternatives to contrast transesophageal echocardiography. We investigated whether dye dilution curves and oximeter recordings are useful for detecting PFO and what is the prevalence of PFO in patients with cryptogenic stroke determined with these bedside methods. We also studied whether stroke risk factors, number of brain lesions, and stroke recurrence rates were different in patients with an unexplained stroke with and without PFO. MATERIAL AND METHODS: Dye dilution curves and oximeter recordings with non-invasive earpiece apparatus were obtained in 59 patients aged under 50 years who had had a cryptogenic brain infarction. The number of ischemic lesions in the brain was counted by MRI. RESULTS: PFO was found in 24 (41%) of 59 patients. There was a 100% concordance in results obtained by dye dilution and by oximetry. Risk factors for stroke were similar in subjects with PFO and those without PFO. No significant association was found between PFO and Valsalva-like activity at stroke onset. Those with PFO did not have more ischemic lesions detected by MRI nor did they have more recurrent ischemic episodes. CONCLUSION: Dye dilution and oximetry are cheap and useful methods for detection of PFO and could be used for screening of the risk of paradoxical embolism. Because these 2 methods were not compared with the golden standard, transesophageal echocardiography, the specificity and sensitivity of the tests remain unsettled.

Adolescent↗
PubMed1992

Sealing ability of sectional injection thermoplasticized gutta-percha technique with varying distance between needle tip and apical foramen.

The purpose of this investigation was to evaluate the influence of the distance of the needle tip from the apical foramen on the apical seal and the length control of the root filling material when thermoplasticized gutta-percha is injected using a sectional injection technique. Ninety-nine human single-rooted mandibular incisors and permanent premolars with straight canals were divided into three equal Groups A, B and C. In Group A the teeth had relatively the wider root canal, in Group C the narrowest, while in Group B root canal size was intermediate. The root canals of all teeth were prepared with a step-back technique. Roots of Group A were instrumented to a Size 70 4 mm short of the working length, while roots of Groups B and C to a Size 70 6 mm and 8 mm short of the working length, respectively. The teeth of all groups were covered with aluminium foil and embedded in acrylic blocks. After the placement of sealer (Roth 811) the root canals of all teeth were obturated with injection-molded thermoplasticized gutta-percha using a three-stage sectional technique. The roots remained in India ink for three days and then cleared by successive immersion in nitric acid, ascending grades of alcohol and finally in xylene. The linear dye penetration and the linear apical underextentionion of the root canal filling were measured by two independent examiners under a stereo microscope. There was no significant difference in the linear dye leakage between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Bicuspid↗
PubMed1994

Patent foramen ovale with left to right shunt in bronchopulmonary dysplasia: coincidental or associated complication?

Despite the use of exogenous surfactants, the incidence of bronchopulmonary dysplasia (BPD) has not decreased as much as expected. Of 208 newborns involved in trials with Exosurf at our center, 51 had BPD. Among these newborns, 8 were found retrospectively to have secondary worsening of respiratory distress syndrome after initial improvement with surfactant treatment. Oxygen requirements decreased from 89 +/- 15% to 58 +/- 16% (mean +/- SD), respectively, before and 48 h after surfactant, and then reached a plateau of 34 +/- 10% before dramatic deterioration at 22 +/- 9 days of life. The patients had signs of cardiac failure and increased oxygen requirements of up to 76 +/- 19% within 6 h. A patent foramen ovale (PFO) was demonstrated at echocardiography with a left to right shunt at Doppler. No other cause of worsening was found. Five infants had significant improvement when treated with digoxin and furosemide. This retrospective study raises questions about the relationship between PFO and BPD that should be explored in a prospective study.

Bronchopulmonary Dysplasia↗
PubMed1983

Intrauterine hydrops caused by premature closure of the foramen ovale.

Intrauterine hydrops was diagnosed by two dimensional echocardiography. The fetus had a pericardial effusion and a thick interatrial septum without a foramen ovale flap. The condition was treated by giving the mother digitalis. Postnatally, the effusion had disappeared and a parachute mitral valve was found.

Digitalis↗
PubMed2003

Anomalous origin of the circumflex artery and patent foramen ovale: a rare cause of myocardial ischaemia after percutaneous closure of the defect.

A 35 year old man with a history of transient ischaemic attack and atrial septal aneurysm underwent percutaneous closure of a patent foramen ovale (PFO) with a transcatheter device. After the procedure the patient developed effort angina not present previously. Transoesophageal echocardiography confirmed the absence of residual shunt but showed an abnormal linear image running behind the aortic root. Magnetic resonance imaging detected an anomalous origin of the circumflex coronary artery from the right coronary sinus. The anomalous artery was located between the aortic root and the PFO closing device, causing coronary insufficiency. This report describes a rare complication of transcatheter PFO closure.

Adult↗
PubMed2004

Percutaneous closure of patent foramen ovale: impact of device design on safety and efficacy.

OBJECTIVE: To compare the safety and efficacy of percutaneous closure of patent foramen ovale (PFO) with the Amplatzer PFO occluder (Amplatzer) or the PFO STAR device (STAR) in patients with presumed paradoxical embolism. METHODS: Implantation characteristics, procedural complications, residual shunt, and recurrence of thromboembolic events were recorded prospectively in 100 consecutive patients undergoing percutaneous PFO closure with the STAR (n = 50) or Amplatzer (n = 50) devices between 1998 and 2001. The study was not randomised. Device implantation was successful in all cases. RESULTS: There were more procedural complications in the STAR than in the Amplatzer group (8/50 v 1/50, p = 0.01). More than one device placement attempt was an independent predictor of procedural complications (odds ratio (OR) 8.5, 95% confidence interval (CI) 1.3 to 55.8; p = 0.03). A residual shunt six months after PFO closure, assessed by transoesophageal contrast echocardiography, occurred more often in the STAR than the Amplatzer group (17/50 v 3/50, p = 0.004), and was predicted in the STAR group by the use of a device with a 5 mm as opposed to a 3 mm disc connector (OR 6.1, 95% CI 1.1 to 34.0; p = 0.04). The actuarial risk of recurrent thromboembolic events after 3.5 years was 16.8% (95% CI 7.6% to 34.6%) in the STAR and 2.7% (95% CI 0.4% to 17.7%) in the Amplatzer group after three years (p = 0.08). CONCLUSIONS: Percutaneous PFO closure with the Amplatzer PFO occluder had fewer procedural complications and was more likely to be complete than with the STAR device. These findings underline the importance of device design for successful percutaneous PFO closure.

Balloon Occlusion↗
PubMed2004

Inheritance of persistent foramen ovale and atrial septal defects and the relation to familial migraine with aura.

OBJECTIVE: To determine whether smaller atrial shunts (large persistent foramen ovale (PFO) and small atrial septal defect (ASD)) are inherited and whether this has a role in the inheritance of migraine with aura. METHODS: Contrast echocardiography was used to detect atrial shunts in 71 relatives of 20 probands with a significantly sized atrial shunt (large PFO or ASD). Four families with three generations, 14 families with two generations, and two sibships were studied. The contrast echocardiograms were performed blind to history of migraine. A consultant neurologist, who was blinded to cardiac findings, categorised migraine symptoms in subjects. RESULTS: The occurrence of atrial shunts was consistent with autosomal dominant inheritance. Usually shunts were large PFOs, but in some cases they were ASDs. There was also evidence that inheritance of more complex congenital heart disease may be related to the inheritance of PFOs. When the proband had migraine with aura and an atrial shunt, 15 of the 21(71.4%) first degree relatives with a significant right to left shunt also had migraine with aura compared with three of 14 (21.4%) without a significant shunt (p < 0.02). CONCLUSIONS: There is dominant inheritance of atrial shunts. This is linked to inheritance of migraine with aura in some families.

Adult↗
PubMed2004

Right ventricular diastolic dysfunction and patent foramen ovale causing profound cyanosis.

A 73 year old woman presented with profound central cyanosis and a history of a minor stroke. She had normal heart morphology, normal pulmonary artery pressure, and a normal coronary angiography. A patent foramen ovale (PFO) with a massive right to left shunt was demonstrated at the atrial level, with normal pulmonary venous saturations and PO2 values. This rare, age related case of right ventricular diastolic dysfunction in a normotensive patient revealed a generous PFO allowing a pronounced right to left shunt.

Aged↗
PubMed2006

Increased frequency of cardioembolism and patent foramen ovale in patients with stroke and a positive travel history suggesting economy class stroke syndrome.

OBJECTIVE: To investigate the frequency of acute stroke in patients with a recent travel history and to analyse risk factors, stroke patterns and presence of a patent foramen ovale (PFO) in this patient group. DESIGN: One-year prospective observational study. SETTING: Single-centre study. METHODS: Enrolling all patients presenting with a first cerebral ischaemia and complementing the usual history with a standardised travel history. RESULTS: Of 338 patients with acute stroke, 42 had a positive travel history (PTH) (12.4%). Patients with a PTH were significantly younger (56.6 (SD 13) years) than patients (66.9 (13.2) years, p = 0.0001) with a negative travel history (NTH). Frequency of PFO in the PTH group (13; 44.8%) was significantly higher than in the NTH group (7; 10.8%) (p = 0.0001), even after patients were dichotomised into two age groups (younger and older than median of all PATIENTS: 31% v 6.1%, p = 0.007 and 13.8% v 4.6%, p = 0.022, respectively). PTH patients had fewer stroke risk factors (2.2 (1.4) v 3.3 (1.6), p = 0.0001) and a different risk profile with a lower frequency of diabetes (11.9% v 31.4%, p = 0.009), hypertension (52.4% v 78.7%, p = 0.0001), atrial fibrillation (7.1% v 22%, p = 0.025) and others (16.7% v 38.9%, p = 0.005). In contrast, PTH patients had significantly more cardioembolic (35.7% v 19.3%, p = 0.023) and cryptogenic strokes (50% v 19.9%, p = 0.0001) and more often ischaemia in the territory of the posterior cerebral artery (29.6% v 6.3%, p = 0.0001). CONCLUSIONS: The finding that more PTH patients had a PFO and a cardioembolic stroke pattern but that fewer had other typical stroke risk factors led to the hypothesis that PFO is a risk factor for economy class stroke syndrome.

Aged↗
PubMed2006

Comparison of transthoracic echocardiography with harmonic imaging with transoesophageal echocardiography for the diagnosis of patent foramen ovale.

The optimal diagnostic method for patent foramen ovale is currently unclear. This study compared bubble contrast second harmonic transthoracic (TTE) and transoesophageal echocardiography (TOE) on 87 consecutive patients referred for TOE for all indications. A right left shunt was diagnosed in 34 cases (39%), with TTE positive in 26 cases (sensitivity 76.5%), TOE positive in 27 cases (sensitivity 79.4%). Pitfalls of TTE included quality of echo and left sided valve lesions, and for TOE the ability to perform an adequate Valsalva manoeuvre. In conclusion, both tests have similar sensitivity and should be viewed as complementary modalities.

Adult↗
PubMed2005

CPAP suppression of awake right-to-left shunting through patent foramen ovale in a patient with obstructive sleep apnoea.

The prevalence of an echocardiographically visible patent foramen ovale (PFO) is higher in patients with obstructive sleep apnoea syndrome (OSAS) than in normal controls. We report a patient who presented with OSAS and right-to-left shunting (RLS) through the PFO in whom the RLS disappeared after treatment for 1 week with nocturnal continuous positive airway pressure (CPAP). This case shows the role of OSA in generating an awake RLS through a PFO and its possible reversibility by CPAP. The mechanism of reversible awake RLS through PFO in OSAS is discussed.

Continuous Positive Airway Pressure↗
PubMed2003

Persistent truncus arteriosus and patent foramen ovale in a Simmentaler x Braunvieh calf.

A Simmentaler x Braunvieh calf had been anorexic during its first 36 hours of life, had a loud heart murmur and was suspected to have pneumonia. In the light of the results of radiographic and echocardiographic examinations, right heart catheterisation and angiography, a diagnosis of persistent truncus arteriosus and patent foramen ovale was made. The diagnosis was confirmed on postmortem examination.

Angiography↗