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Using contrast transcranial Doppler sonography we have observed a PFO in 55%of the patients with TGA,compared with 27%of a control group of 100 patients.This difference was statistically significant(P<.01).Twenty-five patients with TGA(47%),15 of them with a proven PFO,reported a precipitating activity,such as the lifting of heavy weights,immediately before the TGA occurred.In addition to other pathological mechanisms, paradoxical embolism with temporobasal ischemia could possibly play a role in the clinical syndrome of TGA.This hypothesis could explain the frequent observation of preceding Valsalvalike activities in patients with TGA. |
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