Bubble stream reveals functionality of the right-to-left shunt: Detection of a potential source for air embolism

Ismail Burak Parlak, Salih Murat Egi, Ahmet Ademoglu, Peter Germonpré, Ozlem Batukan Esen, Alessandro Marroni, Costantino Balestra

    Research output: Contribution to journalArticlepeer-review

    Abstract

    The existence of a right-to-left shunt may increase the likelihood of micro-embolism by allowing a flux of bubbles under hyperbaric conditions. The aim of the study was to measure the relationship between these shunts and bubbles in 10 consecutive subjects using trans-thoracic and trans-esophageal echocardiography. In video frames, all cardiac chambers were segmented and bubbles were analyzed by our proposed method and two other methods. The relationship with bubbles and shunts was divided into three classes: no bubbles, 1-20 bubbles, >20bubbles and measured over 2160 frames. Our sensitivity was 100% and our specificity was between 90.1% and 96.4%. There were 4.32-23.78 bubbles/frame in the left atrium according to our method. After the automatic analysis, shunts were graded double-blinded by two cardiologists. Consequently, we noted that aperture size does notnecessarily reflect how active the right-to-left shunt is. Instead, our proposed decay curves constitute a better tool for determining functionality.

    Original languageEnglish
    Pages (from-to)330-340
    Number of pages11
    JournalUltrasound in Medicine and Biology
    Volume40
    Issue number2
    DOIs
    Publication statusPublished - Feb 2014

    Keywords

    • Cardiac patent foramen ovale
    • Microembolism
    • Trans-esophageal echocardiography
    • Trans-thoracic echocardiography

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