{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:57:28Z","timestamp":1787025448812,"version":"build-2736575974"},"reference-count":0,"publisher":"Diving and Hyperbaric Medicine Journal","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diving Hyperb Med"],"abstract":"<jats:p>Introduction: Transoesophageal echocardiography (TOE) is claimed to be the investigation of choice for detecting a persistent foramen ovale (PFO) with almost 100% diagnostic accuracy. If true, TOE would detect all large\/clinically significant PFOs.\nMethods: Retrospective analysis to determine the sensitivity of TOE for detection of clinically significant PFOs. Patients were from a consecutive series of 150 patients who had transcatheter closure of a PFO following events attributed to paradoxical embolism (decompression sickness or stroke). In each patient, transthoracic echocardiogram with bubble contrast showed a clinically significant atrial right-to-left shunt. The data reported are from the sub-group of the 150 patients with a clinically significant PFO who also had a TOE performed in other hospitals.\nResults: Twenty seven of 150 consecutive patients had a total of 31 TOEs performed at 22 United Kingdom regional cardiac centres. TOE failed to detect a PFO in 17 of the 27 patients. Four patients had a TOE on two separate occasions and in each case both of the TOEs failed to show a PFO. TOE gave a false negative test in 21 of 31 investigations (sensitivity 32%). The mean PFO diameter was 9.4 mm (median 9 mm, range 5\u221216 mm) in the 21 patients in whom balloon sizing was performed and 9.8 mm (median 10 mm, range 5\u221216 mm) in the 13 patients in whom balloon sizing was performed and a TOE failed to show a PFO.\nConclusions: These finding demonstrate that the precision of TOE for detecting a PFO in real world clinical practice is considerably lower than generally believed.<\/jats:p>","DOI":"10.28920\/dhm56.2.148-153","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:04:32Z","timestamp":1781654672000},"page":"148-153","source":"Crossref","is-referenced-by-count":1,"title":["Real-world experience of transoesophageal echocardiography for detection of clinically significant persistent foramen ovale"],"prefix":"10.28920","volume":"56","author":[{"given":"Peter","family":"Wilmshurst","sequence":"first","affiliation":[{"name":"United Kingdom Diving Medical Committee (UKDMC), United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Pearson","sequence":"additional","affiliation":[{"name":"Shrewsbury and Telford NHS Hospital Trust, Shrewsbury SY3 8XQ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Walsh","sequence":"additional","affiliation":[{"name":"University College Dublin, Dublin, Ireland,  Our Lady\u2019s Hospital for Sick Children, Dublin 12, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W Lindsay","family":"Morrison","sequence":"additional","affiliation":[{"name":"Liverpool Heart & Chest Hospital, Liverpool L14 3PE, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11463","published-online":{"date-parts":[[2026,6,30]]},"container-title":["Diving and Hyperbaric Medicine Journal"],"original-title":[],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:04:33Z","timestamp":1781654673000},"score":1,"resource":{"primary":{"URL":"https:\/\/dhmjournal.com\/index.php?option=com_content&view=article&id=423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,30]]}},"URL":"https:\/\/doi.org\/10.28920\/dhm56.2.148-153","relation":{},"ISSN":["2209-1491"],"issn-type":[{"value":"2209-1491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}