{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T04:33:35Z","timestamp":1748320415133,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Transesophageal echocardiography (TEE) with agitated saline contrast (\u201cbubble study\u201d) is the gold standard for detection of patent foramen ovale (PFO). Standard provocative maneuvers help facilitate right\u2010to\u2010left shunting necessary for diagnosing PFO but may be difficult to implement during TEE. Hypovolemia related to preprocedural fasting may challenge detection of PFO in TEE, and additional optimization measures such as fluid replenishment with passive leg raise (PLR) can enhance PFO detection. We present a 57\u2010year\u2010old male with history of cryptogenic stroke and stubborn PFO which during TEE bubble study responded only to ample fluid replenishment with PLR following a period of prolonged preprocedural fasting.<\/jats:p>","DOI":"10.1111\/echo.15688","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T14:55:39Z","timestamp":1694098539000},"page":"1151-1155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Overcoming a stubborn patent foramen ovale"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3570-8730","authenticated-orcid":false,"given":"John","family":"Gallagher","sequence":"first","affiliation":[{"name":"Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5827-1757","authenticated-orcid":false,"given":"John","family":"Dawdy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Cardiology Wayne State University  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Afonso","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Cardiology Wayne State University  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.86"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12947\u2010021\u201000255\u20100"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1707404"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2020.09.013"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.05.037"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540\u20108175.2006.00272.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010016\u20101407\u20101"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/8756479318816983"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2022.07.017"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/ehaa946.2430"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15688","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T05:41:46Z","timestamp":1697089306000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.15688"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,7]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/echo.15688"],"URL":"https:\/\/doi.org\/10.1111\/echo.15688","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"type":"print","value":"0742-2822"},{"type":"electronic","value":"1540-8175"}],"subject":[],"published":{"date-parts":[[2023,9,7]]},"assertion":[{"value":"2023-06-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}