[The role of transesophageal echocardiography (TEE): case study conducted at the Dax Hospital Center]. / Evaluation de la pratique de l'échocardiographie transœsophagienne (ETO): cas du Centre Hospitalier de Dax.

The purpose of this study is to assess the role of transesophageal echocardiography at the Dax Hospital Center based on indications, patients´ profile, results, cost-effectiveness and consistency with prescribers´ expectations. We conducted a retrospective, cross-sectional, descriptive and analytical study at the Cardiovascular Laboratory of the Dax Hospital Center from January 2016 to December 2018. The study included 434 exams out of 460 requested. The variables of interest were: demographic profile of the study population, indications, results, cost-effectiveness and consistency with prescribers´ expectations. The average age of patients undergoing the 434 exams included was 64.37 years, male patients accounted for 64.29%, with a sex ratio of 1.8. Stroke assessment (63.59%), the search for infective endocarditis (16.12%) and the assessment of the treatment of intracavitary thrombi (11.75%) were the main indications. Prescribers were mainly neurologists (60.83%). The examination was normal in 58.99% of cases. The pathological results (40,78%) were dominated by thrombi in the auricle (27.65%), altered auricle emptying (9.45%), the presence of foramen oval permeable (5.07%), interatrial septal aneurysm (2.53%) and infective endocarditis (2.76%). The exam was cost-effective in 40.78% of cases and the results were consistent with prescribers´ expectations in 39.86% of cases. Our study transesophageal echocardiography showed that the indications were dominated by stroke assessment. TEE is a cost-effective diagnostic test with a low rate of complications, and whose results are in line with practitioners' expectations.

Cerebral paradoxical embolism associated with patent foramen ovale and idiopathic venous thromboembolism in a 31-year-old patient.

Paradoxical embolism is the passage of venous thrombi into the arterial circulation through a pulmonary or intracardiac shunt. We report the management of a 31-year-old patient who initially presented with chest pain and right brachiofacial paresis. A diagnosis of paradoxical cerebral embolism associated with a spontaneous venous thromboembolism and a patent foramen ovale was made. The patient benefited from thrombolytic therapy and lifelong anticoagulation with good recovery. This case showed that percutaneous closure of a patent foramen ovale needs to be discussed individually.