Transcranial color-coded sonography (TCCS) could be an effective screening and risk stratification strategy for decreasing the occurrence of decompression sickness (DCS) in divers with patent foramen ovale (PFO), according to a study published Aug. 18 in JACC: Cardiovascular Imaging.

Jakub Honěk, MD, PhD, et al., assessed the incidence of DCS after PFO screening and risk stratification in 702 divers. Each diver was screened for PFO with TCCS. High-grade PFO divers received either catheter-based PFO closure or conservative diving. For divers with low-grade shunt, the researchers advised using low-grade, conservative diving. The efficacy of TCCS screening and risk stratification was measured based on the DCS incidence before enrollment and during a follow-up.

Results showed that the DCS occurrence significantly decreased in every group except the control group. In addition, researchers reported no DCS events in the closure groups. In the low-grade group, DCS occurrence was similar to the control group. DCS incidence was higher in the high-grade group.

"Our results provide the first evidence that a PFO screening and risk stratification strategy might lower DCS occurrence in a large cohort of divers," the authors conclude. "The incidence of a high-grade PFO was high in this study, and divers benefited from catheter-based PFO closure more than from conservative approach. Therefore, stricter recommendations for divers with a high-grade PFO should be considered."

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Noninvasive Imaging, Sports and Exercise Cardiology, Congenital Heart Disease, CHD and Pediatrics and Imaging, Echocardiography/Ultrasound, Sports and Exercise and Congenital Heart Disease and Pediatric Cardiology, Sports and Exercise and Imaging

Keywords: Diving, Foramen Ovale, Patent, Decompression Sickness, Ultrasonography, Catheters

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