Page 14 - Journal of Structural Heart Disease Volume 5, Issue 5

207 Original Scientific Article
Figure 1. Study flowchart. ESUS: embolic stroke of undetermined sources; TEE: transesophageal echocardiography.
proposed diagnostic assessment for ESUS does not include routine use of transesophageal echocardiog- raphy (TEE).
Patent foramen ovale (PFO) is one of the causes of ESUS, especially in patients with paradoxical em- bolism. The relationship between paradoxical em- bolism and PFO is well documented. Conversely, the gold standard imaging tool in diagnosing PFO is TEE. In addition, percutaneous closure of PFO in pa- tients with embolic strokes was recently deemed to be more effective than medical therapy alone [2, 3, 18]. In the current era of PFO closure, it is important to determine the specific embolic source. However, the distribution of embolic sources in patients with ESUS remains unclear. Additionally, the difference in embolic sources in patients with different ages is
not well described. The aim of the present study was to investigate the distribution of embolic sources in patients with embolic strokes according to their age using routine diagnostic assessments including TEE and to evaluate the distribution of paradoxical embo- lism related to patent foramen ovale (PFO) between younger and older..
Materials and Methods
This was a single-center, retrospective study. Be- tween May 2012 and December 2017, 1801 con- secutive patients with acute ischemic stroke were admitted to the Tokushima Red Cross Hospital in Japan. Figure 1 shows the study flowchart. Of these 1801 patients, 213 (11.8%) fulfilled the ESUS diag-
Takafuji H. et al.
Embolic Sources in Young and Old ESUS Patients