Detection of Right-to-Left Atrial Communication Using Agitated Saline Contrast Imaging: Experience with 1162 Patients and Recommendations for Echocardiography

TTE color flow imaging is too insensitive for PFO screening. TTE ASCi, however, is simple and highly accurate for the detection of right-to-left atrial communication, on the proviso that a dedicated protocol, including correctly implemented PM, is followed. It is recommended that TTE ASCi with PM be considered the primary diagnostic tool for the detection of PFO in clinical practice.