Efficacy analysis of cTCD,cTTE,and TEE in predicting catheter passage during patent foramen ovale closure procedures
HOU Qingwang
CHEN Tongfeng
ZHAO Yipin
WANG Xiaohu
CHEN Chong
CHENG Jiangtao
GUO Xiaoyan
LIU Yancun
LIU Yuhao
Abstract：Objective To evaluate the predictive value of contrast transcranial Doppler(cTCD),contrast trans-thoracic echocardiography(cTTE),and transesophageal echocardiography(TEE)for catheter passage during transcatheter patent foramen ovale(PFO)closure.Methods A retrospective analysis was conducted on 164 patients who successfully underwent transcatheter PFO closure at Fuwai Central China Cardiovascular Hospital between January 2023 and December 2023.All patients were preoperatively screened to exclude organic heart disease and sequentially underwent cTCD,cTTE,and TEE(when necessary)to confirm PFO.Based on intraoperative catheter passage,patients were divided into two groups:Direct passage group(n=109):Catheter successfully passed through the PFO and completed closure in one attempt.Indirect passage group(n=55):Required auxiliary maneuvers(46 cases using a straight-tip supporting catheter,9 cases using guidewire assistance)to complete closure.Preoperative examination results were compared between groups.Receiver operating characteristic(ROC)curves were plotted to analyze the clinical value of preoperative examinations in predicting catheter passage during PFO closure.Results The study included 164 patients[mean age:39.07±15.25 years;64 males(39.02%)].ROC curve analysis revealed significant differences in predictive efficacy among the three modalities:cTCD:AUC=0.685(95%CI:0.598～0.772);cTTE:AUC=0.617(95%CI:0.524～0.710);TEE:AUC=0.776(95%CI:0.696～0.857)(TEE was significantly superior to cTTE,P=0.012);Among combined approaches,TEE+cTCD showed the best predictive performance(AUC=0.775,95%CI:0.705～0.846).Conclusion For predicting catheter passage during PFO closure:cTCD+cTTE demonstrated lower sensitivity but higher specificity than individual cTCD,cTTE,or TEE assessments.TEE combined with either cTCD or cTTE achieved superior specificity.
Keywords：transcranial Doppler ultrasound foaming testtransthoracic echocardiographic contrast echocardiography of right hearttransesophageal echocardiographypatent foramen ovale
Publication Date：2025-11-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：5( 1344-1348 )