Abstract W MP65: Accuracy of Two-Dimensional Echocardiography using Second Harmonic Imaging for the Diagnosis of Intracardiac Right-to-Left Shunt: A Meta-Analysis of Prospective Studies

Background: Right-to-left shunting (RLS), often through a patent foramen ovale (PFO), has been associated with cryptogenic stroke, migraine with aura, and hypoxemia. With emerging observational studies and clinical trials on the subject of PFO and its association with stroke and migraine, there is a need for accurate diagnosis of PFO in patients being considered for transcatheter closure. While transesophageal echo (TEE) bubble study is the current standard reference for diagnosing PFO, transthoracic echo bubble study with second harmonic imaging (TTE-HI) may be a preferable screening test for RLS as it is a non-invasive and low cost technique. The aim of this meta-analysis was to determine the accuracy of TTE-HI compared to TEE used as the reference test. Methods: A systematic review of Medline, Cochrane and Embase was done to look for all the prospective studies assessing for intracardiac RLS using TTE-HI compared to TEE as the reference; both TTE-HI and TEE were performed with a contrast agent and a ma...