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Had TCD done showed PFO surgeon couldn’t find hole

I had a TCD ultrasound done and the results showed positive bubbles going to brain with findings of significant grade 4 right to left shunt
Went into surgery today had the TOE procedure done and the cardiologist couldn’t find the hole? So obviously didn’t have surgery
Can anyone explain how the test results can show those findings and the cardiologist not find the hole
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