Valsalva maneuver procedures in the diagnosis of right-to-left shunt by contrast-enhanced transcranial doppler using agitated saline solution with blood as a contrast agent
Arquivos De Neuro-Psiquiatria
Valsalva maneuver procedures in the diagnosis of right-to-left shunt by contrast-enhanced transcranial doppler using agitated saline solution with blood as a contrast agent
Autor Correspondente: Marcos Christiano Lange | [email protected]
Palavras-chave: contrast media, paradoxical embolism, microbubbles, transcranial doppler, ultrasonography, valsalva maneuver
Resumos Cadastrados
Resumo Português:
Comparar dois momentos diferentes da manobra de Valsalva (MV) com o uso de solução salina com sangue como meio de contraste (MC) para investigação de embolia paradoxal (EP). Método: 42 pacientes foram submetidos a protocolo padronizado de DTCc com a MV em dois momentos diferentes: [1] injeção do MC durante a MV (teste ACduranteMV); [2] injeção de MC antes da MV (teste ACpreMV). Resultados: Exames positivos foram observados em 47 (56%) ACMs testes ACduranteMV e 50 (59.5%) testes ACpreMV, p=0.64. Houve uma correlação quase perfeita entre ambos os testes, rs=0.829 (95% CI 0.61-1.00, p<0.001). Conclusão: O presente estudo demonstra que não existe diferença significativa na positividade de EP pelo DTCc quando são comparados dois momentos diferentes da MV.
Resumo Inglês:
To compare two different timings for the performance of the Valsalva maneuver (VM) using an infusion of agitated saline solution with blood as contrast agent (CA) to right-to-left shunt (RLS) screening. Method: 42 patients were submitted to a standardized contrast-enhanced transcranial doppler (cTCD) to screen for right-to-left shunt (RLS). cTCD technique was done with two different moments of the VM: [1] the CA injection during the VM (CAduringVM test); [2] the CA injection before the VM (CApreVM test). Results: Positive MCA tests were observed in 47 (56%) CAduringVM tests and in 50 (59.5%) CApreVM tests, p=0.64. There was an almost perfect agreement for the positive tests between the CAduringVM and CApreVM test, rs=0.829 (95% CI 0.61-1.00, p<0.001). Conclusion: The present study demonstrates that there is no significant difference in the results of RLS screening by cTCD when two different moments of VM were done.
