Contrast Echocardiography in the ICU and OR
Ultrasound contrast agents can be divided into first-generation and second-generation agents. First-generation hand-agitated saline solutions contain large and unstable air microbubbles which cannot pass through the pulmonary microcirculation and are used only for the opacification of the right side of the heart. These agents have been used for about 40 years to rule out a shunt at the level of the fossa ovalis. Second-generation agents are made of smaller, more standardized and stable microbubbles containing a low-diffusable gas. They can easily cross the pulmonary circulation and provide left ventricular cavity and left ventricular myocardial opacification. These agents are used for better delineation of the endocardial contour and for myocardial perfusion studies.
KeywordsUltrasound contrast agents Patency of the fossa ovalis Myocardial perfusion Coronary flow reserve Graft patency Levovist
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