翻译：对卵圆孔未闭患者的右向左分流程度PFO-RLScTTE静息状态下及Valsalva动作下检出率与cTEE无明显差异检出分流程度高于cTEE；但cTEE时患者在Valsalva动作下配合操作者握拳放置患者腹部按压放松可以显著提升PFO患者右向左分流程度同时结合经食道超声心动图对PFO解剖结构形态诊断结果诊断对PFO治疗及封堵术前评估有较大价值。

Translation: The detection rates of right-to-left shunt degree (PFO-RLS) in patients with patent foramen ovale (PFO) using contrast transthoracic echocardiography (cTTE) at rest and during Valsalva maneuver showed no significant difference compared to contrast transesophageal echocardiography (cTEE), but the detection of shunt degree was higher with cTEE. However, during cTEE, when patients performed the Valsalva maneuver and the operator applied abdominal pressure by making a fist and relaxing, the right-to-left shunt degree in PFO patients could be significantly increased. Combined with transesophageal echocardiography, it has great value in diagnosing the anatomical structure and morphology of PFO and assessing PFO treatment and closure procedures