Novel way of patent foramen ovale detection and percutaneous closure by intracardiac echocardiography: A case report

Abstract

BACKGROUND

Patent foramen ovale (PFO) is the most common congenital heart disease and is associated with several diseases, including stroke and migraine. PFO diagnosis involves transoesophageal echocardiography, transthoracic echocardiography, and transcranial Doppler. Recent studies have shown that intracardiac echocardiography (ICE) can be used to diagnose and guide percutaneous transcatheter closure.

CASE SUMMARY

A 70-year-old male presented with paroxysmal dizziness and limb weakness for the past 3 mo. Magnetic resonance imaging revealed a history of stroke, and a bubble test revealed the presence of PFO. The patient was then transferred to our hospital for PFO closure. Under ICE guidance, the separation of the septum primum and septum secundum was unclear; we then used a Swartz catheter to confirm PFO by applying physical pressure on the right part of the atrial septum without using any contrast. The ICE continuously and clearly guided the procedure.

CONCLUSION

ICE can guide PFO closure in patients with a history of stroke. When PFO is not evident under ICE, a Swartz catheter can be used.

Keywords: Intracardiac echocardiography; Patent foramen ovale; Percutaneous patent foramen ovale closure; Case report

Core Tip: Patent foramen ovale (PFO) is the most common congenital heart disease and is associated with several diseases, including stroke and migraine. PFO diagnosis involves transoesophageal echocardiography, transthoracic echocardiography, and transcranial Doppler. Recent studies have shown that intracardiac echocardiography (ICE) can be used to diagnose and guide percutaneous transcatheter closure. Here, we represent the use of ICE in PFO detection and closure for PFO patient with a history of stroke. Importantly, when PFO is unobvious, Swartz catheter can be used to physically separate the septum primum and septum secundum.