ABSTRACT
Objective: To investigate the occurrence of patent foramen ovale (PFO) in young patients with ischemic stroke. Methods: A total of 198 consecutive young patients with ischemic stroke were selected from either the outpatient or inpatient department of Xuanwu Hospital, Capital Medical University from October 2006 to January 2010. They were divided into a PFO group (n = 125) and a non-PFO group (n =73) according to whether the existence of PFO on tranesophageal echocardiography. The occurrence of PFO was observed by tranesophageal echocardiography and right heart contrast echocardiography. The examinations of the related risk factors were performed in all the patients. Results: Circled digit oneThe patients in the PFO group were younger than those in the non-PFO group (37±10 vs. 43±10). The diffe-rence was statistically significant (P<0.05). Circled digit twoThe stroke-related risk factors, such as the proportions of patients with hypertension, diabetes mellitus, smoking history, and hypercholesterolemia in the PFO group were lower than those in the non-PFO group. The differences were statistically significant (P<0.05). Circled digit three Eighteen patients (14.4%) were complicated with atrial septal aneurysm in the PFO group, and only 5 patients(6.8%) in the non-PFO group. The difference was statistically significant (P=0.018). Circled digit fourThe proportion of patients without any risk factors in the PFO group was higher than that in the non-PFO group. The difference was statistically significant (P<0.05). Conclusion: PFO may be an important cause of ischemic stroke in young patients.
ABSTRACT
From June 1997 to June 2001 intraoperative transesophageal echocardiography(TEE)was used in 493 patients undergoing different cardiovascular operations including correction of congenital heart defect, coronary artery bypass grafting(CABG),cardiac valve replacement and major vascular surgery.The clinical data of these cases were complete and detailed enough for retrospective review.Their cardiac functions were graded to be classⅡ-Ⅳaccording to New York Heart Association(NYHA)classification.The patients ranged in age between 1.6-74 yrs and weighed between 8.5-92 kg.The probe of TEE was inserted in esophagus after tracheal intubation.Preoperative diagnosis was found to be wrong by TEE in 20 cases(4.1%).Additional defect was found in 51 cases(10.3%).The type of operation planned before operation was altered in 52 cases(10.5%). During the operation real time TEE revealed that the operation performed failed to achieve the goal and revision surgery was needed in 24 cases(4.9%).Abnormal hemodynamics and cardiac function were found by TEE after the heart resumed spontaneous beat in 17 cases(3.5%)and appropriate treatment was instituted.Oral and pharyngeal mucous membrane bleeding occurred in 7 cases.There were no serious complications attributable to TEE.Intraoperative TEE is a very useful tool in formulating the surgery,monitoring hemodynamics and assessing immediate results of surgery and is safe and reliable in the hands of trained anesthesiologists.