PMC3205784_01
Transesophageal contrast echocardiography shows the right atrium and the protruding atrial septal aneurysm, both filled with intravenously injected ultrasound contrast microbubbles. Contrast microbubbles (arrows) in the left atrium indicate the presence of a right-left shunt through a patent foramen ovale.
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After intravenous injection of an ultrasound contrast medium (Echovist , BayerVital), numerous contrast microbubbles were detected in the left atrium even without performing a Valsalva-maneuver (Figure 1).
Transesophageal echocardiography shows the PFO occluder in the correct position sealing the PFO in the atrial septum. Colour Doppler imaging shows a venous blood stream (red) arising from the IVC and rebounding at the right-sided part of the occluder device. *Image shows a model of the Amplatz PFO occluder used. LA, left atrium; RA, right atrium.
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Amplatzer PFO occluder device (Figure 2). After the procedure the patient became less symptomatic and the arterial oxygen pressure increased significantly to 68 mm Hg in an upright position while breathing normal room air.