apitkin

This thread is just following the same path that so many previous ones on PFOs have done. Personal experience seems so much more convincing than science. Neither side convinces the other.

To the other doctors here I would just like to point out that our job is to make difficult decisions on the basis of limited and often contradictory information. That is what we are trained to do and we learn to be comfortable with uncertainty. The patient however wants a clear recommendation and often feels unhappy if there appears to be any doubt. Our job is to bridge the gap between the uncertain medical literature and the patient's individual requirement. That is one major reason why these arguments occur in a forum like this.

As far as vested interests are concerned, I can't believe that chamber operators want divers to get bent and would therefore dissuade a diver from being investigated for a PFO. Cardiologists, of course, have a different viewpoint.

Lastly:

TOE = transOesophageal echocardiography (British/Oz/NZ)
TEE = transEsophageal echocardiography (same thing, only American, therefore probably more expensive; also doesn't trip off the tongue quite as well)
TTE = transthoracic echocardiography (the one that doesn't involve having a black 1/2 inch thick probe shoved down your throat, just a load of jelly smeared on your chest)

Andy

(Trained in cardiology, hyperbaric medicine and TEE/TOE)