TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN PATIENTS WITH CEREBRAL ISCHEMIA

سال انتشار: 1386
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 52

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شناسه ملی سند علمی:

JR_RYA-3-3_006

تاریخ نمایه سازی: 3 شهریور 1401

چکیده مقاله:

Abstract INTRODUCTION: Transesophageal echocardiography (TEE) is superior to Transthoracic echocardiography (TTE) in detection of atrial septal defects and aneurysm, aortic atheroma, left atrial thrombus and mitral valve abnormalities. TEE is indicated in young adults with cryptogenic ischemic stroke who are suspected of having cardioembolic mechanism despite non-diagnostic TTE. METHODS: A prospective clinical study was conducted in patients with ischemic stroke or TIA who had TTE done in Ghaem hospital, Mashhad during ۲۰۰۶-۲۰۰۷. Ischemic cerebrovascular events were detected by stroke neurologist. TEE was performed with VIPI۳/GE device, USA and a ۷ MHz transesophageal probe by an echocardiologist. Patients who did not have TTE before TEE were excluded. Comparison of TEE to TTE results was performed by the echocardiologist and stroke neurologist in each patient. Influence of TEE on therapeutic decisions in each patient was evaluated. RESULTS: Forty-seven patients (۲۰ females, ۲۷ males) with a mean age of ۴۲.۶±۷.۳ years were studied. Cardiac and aortic abnormalities were detected in TEE of ۳۵ cases (۳۵/۴۷; ۷۴%) with ischemic cerebrovascular events. Cardiac abnormalities of ۱۷ cases (۳۶%) were only detectable by TEE. These seventeen cases included ۷ patients with PFO, ۱ case with ASD, ۶ cases with aortic atheroma and ۲ patients with clot in the left atrium. Comparing the preventive stroke strategies before and after TEE revealed that it was changed only in two cases (۲/۴۷; ۴.۳%) due to performing TEE. These included one patient with a small high-risk PFO and another case with dehicense of mechanical mitral valve. CONCLUSION: TEE revealed cardiac or aortic abnormalities in one-third of the patients with cerebral ischemia and has not been detected by TEE previously. The influence of TEE in therapeutic decisions of patients with ischemic cerebrovascular events is very low.         Keywords: Transesophageal echocardiography, Stroke, Transient Ischemic Attack.

نویسندگان

Kavian Ghandehari

MD, FLSP, Associate Professor, Neurology Dept. Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Afsoon Fazlinejad

MD, FLSP, Assistant Professor, Neurology Dept. Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Mohammad Farzadfard

MD, Neurologist, Neurology Dept. Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.