{
  "abstract": "Introduction It is highlighted that the prevalence of patent foramen ovale(PFO) in patients with stroke, is estimated from 30% to 50%, specifically, in young patients experiencing a stroke of unrecognised origin . Therefore, it is crucial to understand the early detection of large defect (PFO) and timely closure of large lesion, to prevent further cerebrovascular events(CVA) in this patient population.Objective Our primary aim was to investigate the diagnostic role of bubble contrast echocardiogram for PFO patient population, and our further objectives were to formulate the local guidelines to standardize the novel screening pathway for early detection of defect and to facilitate the early closure of PFO to prevent further CVA events.Method A total of 30 patients admitted with cryptogenic stroke were assessed to investigate the congenital cardiac defect (PFO), from 1st August 2023 to 1st June 2024. Of these, 20 patients were indicated for bubble contrast echocardiogram as a diagnostic screening test (study population). Bubble echocardiogram using agitated saline and Valsalva manoeuvres was assessed for each patient cohort, at outpatient echocardiogram clinic, and the timing of referral for large defect closure was counted from the day patients received positive screening to the next clinic review.Results All patients identified (n=20) had admitted to our tertiary centre with a stroke of unrecognised origin (study population). Mean age was 42.5 years (range 30–55). It was found that 12 out of 20 patients (60%) achieved positive results, while remaining 8 patients were negative in screening. Interestingly, 8 out of 12 positive tests (67%) were concluded as large patent foramen ovale lesion, while remaining 4 patients were found out to have small insignificant defect. Following this screening test, all 8 patients with positive large PFO lesion was immediately referred to structural interventional centre within 6 weeks’ time, facilitating for early defect closure. A multi-disciplinary team discussion was made to improve upon the quality of early diagnostic screening test using bubble contrast echocardiogram for this patient population, and a novel screening pathway was then devised to standardize the PFO screening with its role in implementation science of timely referral of large defect closure to structural interventional centre, to prevent further cerebrovascular events in this patient cohort group.Conclusion The incorporation of bubble contrast echocardiogram as a simple diagnostic tool for detection of certain cardiac defects had led to significant improvement in patient quality of care and potential reduction in risk of further cerebrovascular events . This study highlights the importance of the non-invasive testing as a simple diagnostic tool in detection of congenital cardiac defects and its future role in implementation of timely structural intervention, such as defect closure in large significant lesions.",
  "authors": [
    {
      "affiliations": [
        "University Hospital Plymouth, Plymouth, UK"
      ],
      "name": "Khin Kay Kay Kyaw"
    },
    {
      "affiliations": [
        "University Hospital Plymouth, Plymouth, UK"
      ],
      "name": "San Myint"
    }
  ],
  "title": "6-013 The role of bubble contrast echocardiogram as a diagnostic tool for patent foramen ovale (PFO) patient cohort groups with cryptogenic stroke in a tertiary care centre",
  "uid": "8d96c14e-a1af-59be-a268-3a288f9e3bdb"
}