1. Right-to-left shunt through patent foramen ovale during off-pump coronary artery bypass 
Mariko Morita, MD, Hiroshi Inoue, MD, Atsushi Amano, MD, PhD 
The Journal of Thoracic and Cardiovascular Surgery 
Volume 152, Issue 1, Pages e21-e22 (July 2016)
DOI: /j.jtcvs
Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

2. Figure 1
Mid-esophageal bicaval view shows previously undetected PFO with no shunt flow. TEE, Transesophageal echocardiography; IAS, Interatrial septum; RA, right atrium; LA, left atrium; MI, mechanical index; TIS, soft tissue thermal index.
The Journal of Thoracic and Cardiovascular Surgery  , e21-e22DOI: ( /j.jtcvs )
Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

3. Figure 2
Mid-esophageal bicaval view with color-flow Doppler. A, PFO with no shunt flow while the heart was in normal position. B, PFO with right-to-left shunt flow during heart lifting. TEE, Transesophageal echocardiography; IAS, Interatrial septum; RA, right atrium; LA, left atrium; MI, mechanical index; TIS, soft tissue thermal index.
The Journal of Thoracic and Cardiovascular Surgery  , e21-e22DOI: ( /j.jtcvs )
Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

4. Figure 3
A 3-dimensional TEE image of PFO. A, Systolic phase. B, Diastolic phase. PFO was enlarged during diastolic phase. TEE, Transesophageal echocardiography; MI, mechanical index; TIS, soft tissue thermal index.
The Journal of Thoracic and Cardiovascular Surgery  , e21-e22DOI: ( /j.jtcvs )
Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

5. Color-flow Doppler showing a right-to-left shunt flow through PFO during heart lifting.
The Journal of Thoracic and Cardiovascular Surgery  , e21-e22DOI: ( /j.jtcvs )
Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions