EDGAR BEZERRA DE LIRA FILHO

Índice h a partir de 2011
1
Projetos de Pesquisa
Unidades Organizacionais

Filtros

Limpar filtros

Configurações

Resultados de Busca

Agora exibindo 1 - 2 de 2
  • conferenceObject
    Pulmonary Complications in Right Sided Endocarditis
    (2013) RODRIGUES, Ana Clara T.; KAY, Fernando U.; OGAWA, Andrea; NISHIYAMA, Katia; ARRUDA, Ana Lucia; LIRA FILHO, Edgar; KOWATSCH, Ingrid; FURTADO, Meive; CERRI, Glovanni G.; ANDRADE, Jose L.
  • article 64 Citação(ões) na Scopus
    Importance of Adequately Performed Valsalva Maneuver to Detect Patent Foramen Ovale during Transesophageal Echocardiography
    (2013) RODRIGUES, Ana Clara; PICARD, Michael H.; CARBONE, Aime; ARRUDA, Ana Lucia; FLORES, Thais; KLOHN, Juliana; FURTADO, Meive; LIRA-FILHO, Edgar B.; CERRI, Giovanni G.; ANDRADE, Jose L.
    Background: Transesophageal echocardiography (TEE) plays an important role in evaluating cardioembolic sources of emboli. The identification of a patent foramen ovale (PFO) is reportedly improved with TEE compared with transthoracic echocardiography (TTE), but the Valsalva maneuver during TEE may be difficult or suboptimal. The aim of this study was to assess the efficacy of the Valsalva maneuver for PFO diagnosis using TEE compared with TTE by evaluating patients with ischemic stroke referred for echocardiography. Methods: Only patients able to perform the Valsalva maneuver during TTE were included; efficacy was defined by a 20 cm/sec decrease in transmitral E velocity. A PFO was judged present when microbubbles of agitated intravenous saline were seen in the left chambers within three cycles after right atrial opacification. Results: Of 108 patients (mean age, 55615 years; 61 men), 48 (44%) were judged to have PFOs by TEE and/or TTE. In 36 patients (33% of the total, 75% of those with PFOs), microbubbles were observed both by TEE and TTE, in seven patients only during TTE, and in five patients only during TEE. In patients able to satisfactorily perform the Valsalva maneuver during TEE, 22 PFOs were found, and two shunts (9%) were missed, whereas in patients unable to perform this maneuver, 26 PFOs were observed, with five shunts missed (19%) (P <.05). When a PFO was missed by TTE, either the echocardiographic window was suboptimal or the shunt was small. Conclusions: An adequate Valsalva maneuver is crucial for diagnosis of PFO; most patients with stroke may be screened using TTE with contrast and the Valsalva maneuver, with TEE indicated in case of suboptimal transthoracic images.