Detection of pulmonary arteriovenous fistulae in patient with cirrhosis by contrast 2D echocardiography.

Hind, C. R. K.; Wong, Cyrus

doi:10.1136/gut.22.12.1042

Cited by 48 publications

(15 citation statements)

References 6 publications

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“…cTEE was able to detect trivial‐grade contrast effect (grade I) in 65% of the CG patients, in whom saline microbubbles would not be expected to pass through the normal pulmonary barrier. The diameter of these bubbles varies from 24 to 180 μm, 25 exceeding the pulmonary capillary maximum diameter of 15 μm, where they should be retained under normal conditions 26 . In the absence of vascular abnormalities, this behavior can be partially explained by the presence of “physiological” pulmonary shunts 27–29 .…”

Section: Discussionmentioning

confidence: 99%

Role of Contrast‐Enhanced Transesophageal Echocardiography for Detection of and Scoring Intrapulmonary Vascular Dilatation

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Role of Contrast‐Enhanced Transesophageal Echocardiography for Detection of and Scoring Intrapulmonary Vascular Dilatation

et al. 2010

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“…These considerations strongly suggest that the hepatic venous blood plays a role in preventing the pulmonary arteriovenous fistulae. Patients with hepatic cirrhosis 23,24 develop vascular dilations similar to those found after the bidirectional Glenn operation, impairing the precapillary and capillary regions of the pulmonary vessels. Although abnormal vasoactive agents were found in the hepatic venous blood of patients with cirrhosis 25,26 , most patients with pulmonary arteriovenous fistulae consequent to the bidirectional Glenn operation have normal liver function 20 .…”

Section: Discussionmentioning

confidence: 93%

Contribuição para o diagnóstico e o tratamento das fístulas arteriovenosas pulmonares após a operação de Glenn bidirecional

Santana¹,

Paulista²,

Pontes³

et al. 2004

Arq. Bras. Cardiol.

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ObjectiveTo determine the incidence of pulmonary arteriovenous fistulae (PAVFs) after the bidirectional Glenn operation and the possible independent variables that could influence their appearance; to confirm the use of microbubble contrast echocardiography for the detection of PAVFs; and to test the sensitivity and specificity of pulmonary angiography. MethodsFrom March 1990 to December 1995 patients were operated upon. Their ages ranged from 2 to 132 months (mean, 32.7± 33.6 Conclusion The incidence of PAVFs after the bidirectional Glenn operation was high (37%). The time interval elapsed after the bidirectional Keywords pulmonary arteriovenous fistulae, bidirectional Glenn operation, microbubble contrast echocardiographyCyanogen congenital heart diseases, which behave functionally as univentricular heart, are usually characterized by a poor prognosis, unsatisfactory quality of life, and impossibility of surgical correction that reestablishes the normal cardiac anatomy.In the past 4 decades, several proposals for palliative operations have been tested, initially in experimental animals, and then, if successful, in children with such defects. One of them, the Glenn operation, was based on the principle that systemic venous blood might reach the pulmonary circulation without the participation of the right cardiac cavities. This operation was experimentally proposed by Carlon et al 1 in 1951, successfully performed for the first time by Meshalkin 2 and Bakulev 3 in 1956, and diffused by Glenn 4 in 1958. The classical Glenn operation, as this procedure has been known, remained unaltered for many years. Haller et al 5 experimentally introduced the concept of bilateral partial cavopulmonary anastomosis, in which the continuity between the pulmonary arteries was preserved by a terminolateral anastomosis between the superior vena cava and the right pulmonary artery.Azzolina et al 6 performed that operation for the first time, which became known as the bidirectional Glenn operation. The major advantage of this technique was that the right pulmonary artery, not separated from the confluence, allowed the division of the blood volume of the superior vena cava between both lungs.Mathur and Glenn 7 reported the late evolution of 56 patients out of 63 who underwent the classical Glenn operation and described for the first time the development of pulmonary arteriovenous fistulae in that type of operation. From this publication onwards, other studies reported such complications 8,9 , decreasing the enthusiasm in regard to the classical Glenn operation, which was then abandoned in favor of the bidirectional Glenn operation 6,10 . MethodsFrom March 1990 to December 1995, 59 patients with complex cyanogen congenital heart diseases underwent the bidirectional Glenn operation at our service. Five patients died, 4 immediately after the procedure and one during hospitalization. The 54 survivors comprised the case series of this study. Age, on the occasion of the operation, varied from 2 to 132 (mean, 31.4±33.56; median, 18.5) mont...

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“…In intracardiac right-to-left shunts, these bubbles appear in the left chamber of the heart within 3 heart beats of their appearance in the right chamber of the heart. In intrapulmonary shunts, these bubbles appear within 4 -6th heartbeats [14].…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Uncommon Cause of Cyanosis in a Child

Elfaramawy

2012

Int J Clin Pediatr

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Pulmonary complications may occur as a result of end-stage liver disease, probably due to decreased hepatic clearance or increased hepatic production of circulating cytokines and other vascular growth mediators. We report a case of a female Egyptian patient 15-year-old that presented with cyanosis who was investigated for a long time for being a cardiac patient as she showed no symptoms suggestive of liver affection but eventually she was diagnosed to have hepatopulmonary syndrome. We aim to highlight pulmonary affection secondary to hepatic disease that although rare can lead to significant morbidity in patients with liver cirrhosis.

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Detection of pulmonary arteriovenous fistulae in patient with cirrhosis by contrast 2D echocardiography.

Cited by 48 publications

References 6 publications

Role of Contrast‐Enhanced Transesophageal Echocardiography for Detection of and Scoring Intrapulmonary Vascular Dilatation

Role of Contrast‐Enhanced Transesophageal Echocardiography for Detection of and Scoring Intrapulmonary Vascular Dilatation

Contribuição para o diagnóstico e o tratamento das fístulas arteriovenosas pulmonares após a operação de Glenn bidirecional

A Case Report of Uncommon Cause of Cyanosis in a Child

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