Published in
Academia Brasileira de Neurologia - ABNEURO, Arquivos de Neuro-Psiquiatria, 3(68), p. 410-413, 2010
DOI: 10.1590/s0004-282x2010000300016
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Valsalva maneuver procedures in the diagnosis of right-to-left shunt by contrast-enhanced transcranial doppler using agitated saline solution with blood as a contrast agent
,
Viviane Flumignan Zétola,
Zétola,Viviane Flumignan,
Elcio Juliato Piovesan,
Piovesan,Elcio Juliato,
Lineu César Werneck,
Werneck,Lineu César
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Abstract
OBJECTIVE: To compare two different timings for the performance of the Valsalva maneuver (VM) using an infusion of agitated saline solution with blood as contrast agent (CA) to right-to-left shunt (RLS) screening. METHOD: 42 patients were submitted to a standardized contrast-enhanced transcranial doppler (cTCD) to screen for right-to-left shunt (RLS). cTCD technique was done with two different moments of the VM: [1] the CA injection during the VM (CAduringVM test); [2] the CA injection before the VM (CApreVM test). RESULTS: Positive MCA tests were observed in 47 (56%) CAduringVM tests and in 50 (59.5%) CApreVM tests, p=0.64. There was an almost perfect agreement for the positive tests between the CAduringVM and CApreVM test, r s=0.829 (95% CI 0.61-1.00, p<0.001). CONCLUSION: The present study demonstrates that there is no significant difference in the results of RLS screening by cTCD when two different moments of VM were done.