eMedicine Specialties > Pediatrics: Cardiac Disease and Critical Care Medicine > Cardiology
Atrial Septal Defect, Patent Foramen Ovale: Multimedia
Updated: Mar 18, 2009
Multimedia
 | Media file 1: This 2-dimensional echocardiogram in an infant (subcostal long-axis view) shows a patent foramen ovale. Right atrium (RA) and left atrium (LA). |
 | Media file 2: Color Doppler of the patent foramen ovale (PFO) seen in Media file 1. A small amount of left-to-right flow is present. This left-to-right flow pattern is typical for PFO seen in newborn infants. |
 | Media file 3: Transesophageal echocardiogram showing the atrial septum. The "flap" of the septum primum is seen. The diagnosis of patent foramen ovale (PFO) cannot be made until right-to-left bubble contrast is demonstrated. LA = Left atrium; RA = Right atrium. |
 | Media file 4: Bubble-contrast injection during Valsalva maneuver. The "flap" of the foramen ovale is opened and bubbles are seen crossing from the right atrium to the left atrium (arrow). |
 | Media file 5: Transesophageal echocardiogram revealing a 25-mm Amplatzer patent foramen ovale (PFO) occluder in place across the PFO shown in Media files 3-4. |
 | Media file 6: Transesophageal echocardiogram of a patent foramen ovale (PFO) closed with 25-mm Amplatzer PFO occluder. Bubble-contrast study with Valsalva post–device placement shows no residual right-to-left bubble passage. |
 | Media file 7: Transcranial Doppler (TCD) study with bubble-contrast study. A Doppler probe is used to interrogate the right middle cerebral artery. Frame 1 shows normal findings. Note the absence of bubble artifact of Doppler signal in the middle cerebral artery. Frame 2 shows strongly positive (5/5) bubble transit seen in a patient with a patent foramen ovale (PFO) during Valsalva maneuver. TCD is a useful screening tool for PFO because of its ease-of-use and ability to easily quantify the amount of potential right-to-left shunt. One of the pitfalls is the inability to differentiate between other sources of right-to-left shunt, such as pulmonary arteriovenous malformation and a PFO. |
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This feature requires the newest version of Flash. You can download it here. | Media file 8: Transesophageal echocardiogram of bubble contrast study showing right-to-left passage of bubble-contrast with a Valsalva maneuver. RA = Right atrium. LA = Left atrium. Arrow shows bubble passage to LA. |
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This feature requires the newest version of Flash. You can download it here. | Media file 9: Transesophageal echocardiogram showing a 10-mm Amplatzer Septal Occluder in place across a patent foramen ovale. |
More on Atrial Septal Defect, Patent Foramen Ovale |
| Overview: Atrial Septal Defect, Patent Foramen Ovale |
| Differential Diagnoses & Workup: Atrial Septal Defect, Patent Foramen Ovale |
| Treatment & Medication: Atrial Septal Defect, Patent Foramen Ovale |
| Follow-up: Atrial Septal Defect, Patent Foramen Ovale |
 Multimedia: Atrial Septal Defect, Patent Foramen Ovale |
| References |
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References
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Further Reading
Keywords
atrial septal defect, patent foramen ovale, ASD PFO, interatrial communication, congenital heart defect, left-to-right shunting, right-to-left shunting, incompetent valve of the fossa ovalis, right atrial enlargement, left atrial enlargement, paradoxical embolism, mitral valve stenosis, mitral valve regurgitation, patent ductus arteriosus, ventricular septal defect, tricuspid valve stenosis, right ventricular hypoplasia, tricuspid atresia, total anomalous pulmonary venous return, migraine headaches, deep venous thrombosis, hypoplastic left-sided heart syndrome, stroke, transient ischemic attacks
