Open AccessDiagnostic accuracy of carotid doppler ultrasound for the detection of right-to-left cardiac shunt
Author(s) -
Anna Marenghi,
Elisa Ceriani,
Elisa Maria Fiorelli,
Mattia Bonzi,
Nicola Montano,
F Ani
Publication year - 2020
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/jcecho.jcecho_70_20
Subject(s) - medicine , transcranial doppler , patent foramen ovale , valsalva maneuver , ultrasound , radiology , right to left shunt , shunt (medical) , cardiology , internal carotid artery , percutaneous , blood pressure
Right-to-left cardiac shunt is a condition anatomically related to patent foramen ovale (PFO) and potentially related to cryptogenic cerebrovascular events. As recent studies demonstrated a reduction of recurrent stroke in patients undergoing percutaneous PFO closure after a cryptogenic cerebrovascular event, it is now of pivotal importance to screen these patients for Right-to-left shunt(RLS) presence. At this regard, transcranial color Doppler (TCCD) with contrast has a good sensitivity (97%) and specificity (93%) compared to transesophageal echocardiography and became the test of choice to assess RLS presence, thanks to its noninvasive nature. However, temporal bone window is not accessible in 6%-20% patients. Several approaches have been explored to overcome this limitation with encouraging but not definitive results for extracranial internal carotid artery (ICA) approach, proposed in previous pivotal studies. Aims of this study were to further assess the diagnostic accuracy of ICA Doppler ultrasound with contrast for RLS detection compared to TCCD, with the two tests performed simultaneously.