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Patent Fossa Ovale


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20% of adults may have intermittently patent fossa ovale (PFO). That patency, with potential right-to-left shunt demonstrable on TEE by color doppler imaging shown on the left, or intravenous agitated saline contrast injection, may account for paradoxic embolus and stroke. PFO shunting may be continuous left to right, or right to left by provokable maneuvers that raise right atrial pressure (cough, Valsalva, straining). Redundant (aneurysmal) interatrial fossa tissue carries a higher likelihood of PFO.

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