Atrial septal aneurysm (ASA) is a localised "saccular" deformity which protrudes to the right or the left atrium or on both sides. It is a rare, but well recognised cardiac abnormality. It is usually an incidental finding or may presents as atrial arrhythmias or arterial embolism. Though it is an acyanotic congenital heart disease but it may result in significant right to left shunt and cyanosi...

BACKGROUND AND PURPOSE Right to left shunt is involved in conditions in which postural changes may be pathogenically relevant. The aim of this work was to assess the frequency of posturally dependent right to left shunt. METHODS In 109 consecutive right to left shunt-positive subjects (male/female=40/69, age 43+/-12 years), we assessed with contrast-enhanced transcranial Doppler the bubble lo...

The 100% oxygen shunt test for detecting right-to-left anatomical shunting was originally described 70 years ago. However, its clinical value is not yet established. We conducted an audit in 80 patients undergoing the test between 1996 and 2012 in a tertiary referral centre. A significant difference (p=0.02) existed between the median shunt percentages where anatomical shunting was identified (...

At present, it is unknown why patients suffering from severe pulmonary hypertension (PH) benefit from atrial septostomy (AS). Suggested mechanisms include enhanced filling of the left ventricle, reduction of right ventricular preload, increased oxygen availability in the peripheral tissue, or a combination. A multiscale computational model of the cardiovascular system was used to assess the eff...

BACKGROUND The purpose of this study was to evaluate the role of intracoronary shunt during off-pump coronary artery bypass surgery. METHODS Fifty-six patients undergoing off-pump coronary artery bypass using the left internal mammary artery to bypass the left anterior descending coronary artery were randomly assigned to have the bypass performed with intracoronary shunt or by occlusive snari...

men ovale with major shunt and moderately dilated right ventricle. Inhaled NO was started. This immediately improved oxygenation (Pao2=Fio2 78 mm Hg) and the thermodilution curve (Fig. 1B) despite persistent and unchanged norepinephrine dose of 1 mg kg min 1 and same ventilatory settings. NO was titrated to 20 ppm. Twelve hours later norepinephrine was reduced to 0.3 mg kg min 1 and NO was redu...

BACKGROUND Right-to-left vascular shunts are associated with brain abscess. CASE REPORT We present a 47-year-old female with a cryptogenic left thalamic abscess on which Streptococcus mitis grew upon aspiration. Computed tomography of the chest with contrast agent revealed an anomalous connection between the left superior pulmonary and brachiocephalic veins. A right-to-left shunt was confirme...

OBJECTIVE The purpose of this study was to evaluate whether intracoronary shunt usage reduced the myocardial damage on the basis of the cardiac markers when compared with the shuntless anastomosis in off-pump coronary artery bypass grafting (OPCABG) surgery of isolated left anterior descending artery lesions. METHODS Forty patients who had stable angina with isolated left anterior descending ...