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Abstract Details

Utility Of Transthoracic Echocardiogram Compared With Transesophageal Echocardiogram For Cardioembolic Source Detection In Patients With Acute Ischemic Stroke: A Retrospective Cohort Study In A Third Level Hospital In Buenos Aires, Argentina.
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (5:30 PM-6:30 PM)

Up to 30% of AIS are cardioembolic. Therefore, a correct assessment relies on early identification of the embolic source. For this reason, echocardiography is fundamental for proper diagnosis and treatment. However, it is still unclear which patients might benefit more from TEE rather than TTE.

To establish the proportion of cardioembolic sources on TEE vs TTE in patients with acute ischemic stroke (AIS) work-up.
A retrospective cohort study was conducted between October 1st, 2015, and September 30th, 2022, which included adults with AIS who underwent both TEE and TTE. Patients with small vessel occlusion or large artery atherosclerotic stroke were excluded. Major and minor cardioembolic sources were defined according to the ACE guidelines classification.  Demographical, clinical and paraclinical data were collected from electronic records.

A total of 170 patients were included. Median age was 74 (IQR 19.8) and 44.1% were male. A cardioembolic source was found in 10.6% (18/170) of TTE and 37.6% (64/170) of TEE, having a statistically significant difference  (χ2=27.7, p<0.01). This difference was still significant when stratified in both major and minor sources (p<0,01). 94.4% (17/18) of those found on TTE were also visible on TEE and only one wasn’t (left ventricle akinetic segment). 

On TEE, main major sources were akinetic left ventricular segment (10.9%) and intracardiac vegetation (7.8%), while most frequent minor sources were patent foramen ovale (PFO) (43.8%), atrial septal aneurysm (25%) and spontaneous atrial echo contrast (15.6%). On TTE main major findings were akinetic left ventricular segment (33.3%) and intracardiac vegetation (16.7%), while most frequent minor finding was atrial septal aneurysm (33.3%).

The proportion of minor, major and total cardioembolic sources findings on TEE were statistically higher compared to TTE. 

Rocio Veronica Marquez, MD (Hospital Italiano de Buenos Aires)
Dr. Marquez has nothing to disclose.
Alejandra Heriz Alejandra Heriz has nothing to disclose.
Jeremias Sebastian Ayerbe, MD (Hospital Italiano de Buenos Aires) Mr. Ayerbe has nothing to disclose.
Guido Stupenengo, MD (Hospital Italiano de Buenos Aires) Dr. Stupenengo has nothing to disclose.
Otto Jesus Vega, Sr., MD, PhD (hospital italiano) Dr. VEGA VEGA has nothing to disclose.
Juan Pablo Rodriguez (Hospital Italiano de Buenos Aires) No disclosure on file
Facundo Escandon, Sr., MD (Hospital Italiano de Buenos Aires) Dr. Escandon has nothing to disclose.
Rodrigo Joaquin Sanjinez, Sr., MD (Hospital Italiano de Buenos Aires) Dr. Sanjinez has nothing to disclose.
Natalia Balian Natalia Balian has nothing to disclose.
Marcelo Rugiero Rodriguez Marcelo Rugiero Rodriguez has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi.