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Thread: PFO closure and toe/tee result

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    RBW Member enrico68 is an unknown quantity at this point enrico68's Avatar
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    PFO closure and toe/tee result

    Good morning everyone, three years ago, after a neurologic dci, I underwent a PFO closure in my hometown, Milan. The first check, after six months,done through a tte, still showed a passage of bubbles into the left atrium, so I waited two full years to do the test again. A few weeks ago, the surgeon that closed the pfo, checked my heart again; the toe did not show any passage, after twenty minutes of testing and Valsalva maneuvers. The tee showed a sporadic passage, probably due to a small pulmonary shunt. I will see another iperbaric center, for a second opinion, but I would like to know if there is a doctor here who can give me an opinion, although through the internet without seeing my tests. I would like to switch from oc to reb diving, for technical diving, and before doing it, I would like to know that the shunt showed is not going to be a problem. I spoke to a lot of people and doctors, before going through the pfo closure, but I did not know about polmonary shunts, so I don't know what to think. Let's just say I would like some peace of mind, before I get back into the water, thanks for any reply, good day

    Enrico

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    RBW Member MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV's Avatar
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    Re: PFO closure and toe/tee result

    Enrico,
    pulmonary shunts are a normal thing, bigger, when "idling", smaller with moderate work.
    To differentiate the source of still existent bubbles, one has to calculate the time for the bubble source (like Echovist solution) to travel from the point of venous injection, through the heart, and up to the artery which is monitored by the doppler head.
    Bubbles appearing in this time window are suspected to take the heart passage, others should be regarded as changing lanes in the lungs via the shunt mechanism.
    I had this examen done at the medical clinic at the University of Ulm, Germany, during a PF0/Neurolesions study.

    Matthias

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    RBW Member enrico68 is an unknown quantity at this point enrico68's Avatar
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    Re: PFO closure and toe/tee result

    Quote Originally Posted by MatV  View Original Post
    Enrico,
    pulmonary shunts are a normal thing, bigger, when "idling", smaller with moderate work.
    To differentiate the source of still existent bubbles, one has to calculate the time for the bubble source (like Echovist solution) to travel from the point of venous injection, through the heart, and up to the artery which is monitored by the doppler head.
    Bubbles appearing in this time window are suspected to take the heart passage, others should be regarded as changing lanes in the lungs via the shunt mechanism.
    I had this examen done at the medical clinic at the University of Ulm, Germany, during a PF0/Neurolesions study.

    Matthias
    Hi MatV, all the doc could tell me is that the bubbles show up in the left atrium, but could not say more on the source; looks like I'll have to go through more exams, does the one you underwent have a specific name? I could tell my doc next week, maybe that is what I need to take too, regards

    Enrico

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    RBW Member MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV is a jewel in the rough MatV's Avatar
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    Re: PFO closure and toe/tee result

    Quote Originally Posted by enrico68  View Original Post
    Hi MatV, all the doc could tell me is that the bubbles show up in the left atrium, but could not say more on the source; looks like I'll have to go through more exams, does the one you underwent have a specific name? I could tell my doc next week, maybe that is what I need to take too, regards

    Enrico
    Enrico,
    pardon,my memory, this was in 1996.. The technique to gather data was called transcranial colour dopplering, and they had a color screen which showed my arteriel cross-section while the speed profile of the blood was shown in different colours, so you could see a perfect parabel like it should be. I think this is an option to otherwise acoustic only measurements, which gives this crackling sound overlaid to the bloodstream and pulsebeat noise.
    I had a device strapped to my had which held the US-Probe fixed to my temple arteria.

    I think your Dr. will know when you tell him what I wrote.

    Regards,
    Matthias

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