The value of transesophageal echocardiography in the investigation and management of cryptogenic cerebral ischemia

a single-center experience

Aristeidis H. Katsanos, Dimitrios Patsouras, Georgios Tsivgoulis, Maria Kosmidou, Konstantinos H. Katsanos, Athanassios P. Kyritsis, Sotirios Giannopoulos

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The diagnostic utility of transesophageal echocardiography (TEE) has often been challenged in patients with cryptogenic stroke (CS). We estimated the prevalence of different findings on TEE examination of CS patients, their impact on secondary stroke prevention and the presence of potential age or gender disparities. We reviewed all TEE examinations that were performed in a single echocardiography laboratory during a 7-year-old period to identify CS patients that underwent investigation with TEE. Of the 518 total TEE examinations, we identified 88 CS patients. TEE revealed abnormal findings in 69.3 % of them. Patent foramen ovale (PFO) and atrial septal aneurysm (ASA) were identified in 30.6 and 22.7 % of the patients. Ascending aorta and aortic arch atheromatosis was present in 26.1 % of the patients, with complex atheromatosis diagnosed in 14.7 % of them. Cardiac myxomas were uncovered in 2.3 %. Thrombi in the left atrium and in cardiac valves were reported in 3.4 and 2.3 % of the patients, respectively. Based on TEE findings, the therapeutic management would be very likely modified in 9.1 % of the patients. Subgroup analysis revealed no gender disparities on the prevalence of TEE findings and in secondary stroke prevention, while linear regression analyses revealed significant associations of age with the prevalence of PFO, ASA, aorta atheromatosis and complex aorta atheromatosis. TEE examination should be included in the diagnostic work-up of all CS patients, irrespective of age and gender status, since it can reveal potential sources of embolism and has a significant impact for secondary stroke prevention.

Original languageEnglish (US)
Pages (from-to)629-632
Number of pages4
JournalNeurological Sciences
Volume37
Issue number4
DOIs
StatePublished - Apr 1 2016

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Transesophageal Echocardiography
Brain Ischemia
Stroke
Secondary Prevention
Aorta
Patent Foramen Ovale
Aneurysm
Myxoma
Heart Valves
Embolism
Heart Atria
Thoracic Aorta
Echocardiography
Linear Models
Thrombosis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Dermatology
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

The value of transesophageal echocardiography in the investigation and management of cryptogenic cerebral ischemia : a single-center experience. / Katsanos, Aristeidis H.; Patsouras, Dimitrios; Tsivgoulis, Georgios; Kosmidou, Maria; Katsanos, Konstantinos H.; Kyritsis, Athanassios P.; Giannopoulos, Sotirios.

In: Neurological Sciences, Vol. 37, No. 4, 01.04.2016, p. 629-632.

Research output: Contribution to journalArticle

Katsanos, Aristeidis H. ; Patsouras, Dimitrios ; Tsivgoulis, Georgios ; Kosmidou, Maria ; Katsanos, Konstantinos H. ; Kyritsis, Athanassios P. ; Giannopoulos, Sotirios. / The value of transesophageal echocardiography in the investigation and management of cryptogenic cerebral ischemia : a single-center experience. In: Neurological Sciences. 2016 ; Vol. 37, No. 4. pp. 629-632.
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