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Master Thesis

Évaluation du doppler trans-crânien comparé à l’échographie cardiaque pour la détection des shunts vasculaires droit gauche en pratique courante

Abstract : Background : the transcranial doppler (DTC) is more and more used for the detection of left to right shunts (SDG). The transesophageal echocardiography (ETO) is still considered as the reference despite some studies showing false negative results compared to the DTC ones. Methods : we have studied retrospectively the patients who is admitted for a DTC, with mico-embolic signal (MES), in the vacular médical unit of university hospital of Bordeaux, during 35 month. This results have been compared with ETO and transthoracic echocardiography (ETT). Results : our study is based on a sample of 101 patient who for the SDG research. It has been detected by one of the mentionned methods in 55 cases. 29,1% by transthoracic echocardiography (ETT), 63,3% by ETO and 96,4% by DTC. 3 patients are positive at DTC and negative at ETO. Contrariwise, there is one DTC negative but positive ETT and one DTC negative and suspicious ETO case. We can also observe that 6 patients have no temporal bone window and cannot have contrast DTC but 15 patients could not have ETO because of invasive characteristic of this test. The analysis of our cohort report more than 52% of SDG in the pardoxical emboli suspect population. Conclusion : DTC, less invasive, could have a strategic place in the first intention SDG detection, for systemic embolism suspect patients. Then, in a second time, ETO can support.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01486101
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Submitted on : Thursday, March 9, 2017 - 4:25:11 PM
Last modification on : Wednesday, August 23, 2017 - 4:30:01 PM
Long-term archiving on: : Saturday, June 10, 2017 - 2:40:14 PM

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Antoine Pavero. Évaluation du doppler trans-crânien comparé à l’échographie cardiaque pour la détection des shunts vasculaires droit gauche en pratique courante. Médecine humaine et pathologie. 2017. ⟨dumas-01486101⟩

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