Transesophageal contrast echocardiography, open foramen ovale and aneurysm of the atrial septum. Experiences with D-galactose suspension

Abstract

The advantages of transesophageal echocardiography using a D-galactose suspension rather than conventional ultrasonic contrast medium for the detection of a cardiac source of peripheral embolism was to be investigated. In 100 patients consecutively examined with transesophageal echocardiography applying a conventional ultrasonic contrast medium the examination was repeated adding a Valsalva test and using a solution of D-galactose (Echovist-300, Schering AG) as contrast medium. With conventional contrast media, 5 interatrial shunts only (2 ASD, 3 patent foramina ovalia, PFO) were detected. Completion of echocardiography with a systemic Valsalva test and use of Echovist-300 resulted in the diagnosis of another 40 PFO. In 17 of 26 patients having an atrial septal aneurysm, an interatrial shunt (1 ASD, 16 PFO) was demonstrated. The use of a solution of D-galactose as contrast medium appears to increase the sensitivity of echo-cardiography for demonstrating a cardiac source of peripheral embolism.