Incorporation of robotic automated transcranial Doppler to screen for patent foramen ovale (PFO) and quantify right-to-left shunt severity in the evaluation of ischemic stroke patients for etiology and PFO management.

Background: Right-to-left shunt (RLS) associated with patent foramen ovale (PFO) is common among cryptogenic strokes. Current diagnostic tools have limitations. Transthoratic echocardiography (TTE) is not as sensitive as Transesophageal echocardiography (TEE), TEE is invasive, and manual transcranial Doppler (TCD) requires trained staff to operate.