TEE is effective for both diagnosing a large secundum ASD and guiding its percutaneous closure in a patient presenting with stroke.
May support TEE-guided ASD closure in stroke; hypothesis-generating and requires prospective validation before broader adoption.
A 36 year-old woman without significant past medical history was admitted with left-sided hemiparesis. Imaging studies confirmed a right middle cerebral artery (MCA) stroke with normal carotid arteries. Transesophageal echocardiogram (TEE) showed right heart enlargement and a large secundum atrial septal defect (ASD) (Figure Using TEE guidance, an ASD occluder device was placed without complication (Figure
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Peterson et al. (2003) studied this question.
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