Abstract: Objective To explore and analysis the diagnostic values of transesophageal echocardiography and dual source coronary CT angiography in right to left shunt (RLS) of patent foramen ovale (PFO). Methods From April 2020 to May 2023, 210 cases of cardiovascular disease patients diagnosed and treated at a certain hospital were selected as the research subjects. All patients were underwent transesophageal echocardiography and dual source coronary artery CT angiography, and imaging features were recorded. And all patients were undergone pathological examination and diagnostic value were calculated. Results In the 210 patients, there were 42 cases were diagnosed with right to left shunt of patent foramen ovale (PFO group), accounting for 20.0%. The left atrial diameter and pulmonary artery pressure in the PFO group were significantly higher than those in the non PFO group (P<0.05), and the left ventricular ejection fraction were significantly reduced compared to the non PFO group (P<0.05). In the 210 patients, there were 46 cases diagnosed with right to left shunt of patent foramen ovale by transesophageal echocardiography, including 28 cases of grade Ⅰ, 10 cases of grade Ⅰ, and 8 cases of grade Ⅲ. The sensitivity and specificity of transesophageal echocardiography in diagnosing right to left shunt of patent foramen ovale were 97.62% (41/42) and 97.02% (163/168), respectively. And there were 43 cases of right to left shunt of patent foramen ovale were diagnosed by dual source coronary artery CT angiography. The sensitivity and specificity of dual source coronary artery CT angiography in diagnosing right to left shunt of patent foramen ovale were 100.00% (42/42) and 99.40% (167/168), respectively. The ROC curve shows the maximum area under the curve of transesophageal CT angiography with double source coronary CT angiography of 0.875 and 0.882, and it has a certain degree of accuracy. Conclusion Compared to transesophageal echocardiography, dual source coronary artery CT angiography has a better diagnostic effect on right to left shunt of patent foramen ovale.

Key words: transesophageal echocardiography, patent foramen ovale, right to left diversion, dual source coronary artery CT angiography, sensitivity, specificity