Cardiac Magnetic Resonance Imaging and Transesophageal Echocardiography in Patients With Transcatheter Closure of Patent Foramen Ovale
Thorsten Nusser, MD1,
Martin Höher, MD, FESC,
Nico Merkle, MD,
Olaf C. Grebe, MD,
Jochen Spiess, MD,
Hans A. Kestler, PhD,
Volker Rasche, PhD,
Matthias Kochs, MD,
Vinzenz Hombach, MD* and
Jochen Wöhrle, MD, FESC1
Department of Internal Medicine II–Cardiology, University of Ulm, Ulm, Germany.
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Figure 1 The time intensity curves of the same patient as in Figure 2 during a contrast-enhanced cardiac magnetic resonance imaging study while performing a Valsalva maneuver. The blue line represents the signal intensity in the right atrium, and the red line denotes the signal increase in the left atrium. The blue line shows its maximal peak earlier than the red line because of the earlier contrast enhancement of right versus left atrium after intravenously administered contrast agent. The black arrow indicates the contrast passage over the patent foramen ovale showing an additional smaller peak before the maximal peak in the left atrium.
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Figure 2 A series of steady-state free-precession sequences in a patient with patent foramen ovale and atrial septal aneurysm. (A) A four-chamber view and (B) a short-axis view before interventional closure. The two arrows indicate the separated atrial septum. The same patient at 12-month follow-up after transcatheter closure in (C) a four-chamber view and (D) a short-axis view. The arrows point at the closure device (for cine sequences, see Online ).
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Figure 3 This plot shows the grade of provocable right-to-left shunting over patent foramen ovale (PFO) in 75 patients assessed by transesophageal echocardiography (TEE) before transcatheter closure, after device implantation, and at follow-up.
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Figure 4 A new structure next to the right atrium was seen on cardiac magnetic resonance imaging 3 months after interventional closure of a patent foramen ovale. (A) Four-chamber view steady-state free precession sequence, (B) proton-weighted coronal turbo spin echo. After 25 months the supposed hematoma had completely disappeared, which is shown in (C) and (D), images acquired by a T2-weighted black-blood technique.
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