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Minerva Anestesiologica 1999 November;65(11):815-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Contrast echocardiography and transcranial Doppler sonography for detection of a patent foramen ovale

Papadopoulos G. S., Zauner A., Brpck M.

Department of Anaesthesiology and Operative Intensive Care Medicine, Medical School University of Ioannina Greece, B Franklin Hospital, Free University of Berlin - Germany


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We ­report the ­case of a ­patient, in ­whom a ­patent ­foramen ­ovale was ­detected. For the detec­tion of a ­patent ­foramen ovale sim­u­la­tion of ­Valsalva’s ­manoeuvre ­with a pos­i­tive ­airway pres­sure of 20 cm H2O was ­applied. ­Change of ven­ti­la­tion ­manoeuvre by ven­ti­la­tion ­with pos­i­tive ­airway pres­sure of 35/30/15 cm H2O at a ­tidal ­volume of 1200 ml ­make a dis­tinct ­increase in pas­sage of con­trast ­medium ­from the ­right to the ­left ­atrium. ­These find­ings ­were ­detected by con­trast tran­se­soph­a­geal ech­o­car­di­og­raphy and indi­rectly by trans­cra­nial Dop­pler sonog­raphy and ­were repro­du­cible. ­This may ­stress the impor­tance of pre­op­er­a­tive ­screening of ­patent ­foramen ­ovale in ­patients to be oper­ated on in the sit­ting posi­tion. Con­trast ech­o­car­di­og­raphy and the ven­til­a­tory ­manoeuvre ­with ­high ­airway pres­sure and ­PEEP ­might ­increase the detec­tion ­rate of ­patent ­foramen ­ovale ­with a ­right to ­left ­shunt ­during gen­eral ­anaesthesia.

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