A patient with a large hydatid cyst of the liver developed a positionally symptomatic right to left shunting across a patent foramen ovale with both platypnoea and orthodeoxia, despite normal pulmonary arterial pressures and normal pulmonary function tests. When the patient was in the supine position the calculated right to left shunt was 15.1% and 29.5% when seated. The shunt was attributed to...

A 60-year-old man was readmitted 1 year after bioprosthetic aortic valve replacement for recurrent endocarditis. Transthoracic 2-dimensional color Doppler revealed a novel finding of a left-to-right shunt from the left ventricular outflow tract to the right atrium immediately superior to the septal leaflet of the tricuspid valve consistent with an acquired Gerbode defect. Real-time 3-dimensiona...

A 63 year old female presented to hospital with progressive exertional dyspnoea over a 6 month period. In the year preceding her admission, she reported an intercurrent history of abdominal pain, diarrhoea and weight loss. She was found to be hypoxic, the cause for which was initially unclear. A ventilation-perfusion scan identified a right-to-left shunt. Transoesophageal echocardiography (TOE)...

There are some controversies regarding the usefulness of leaving additional pulmonary blood flow when establishing a bidirectional cavopulmonary shunt. From April 2002 to September 2008, 13 patients (mean age, 24 +/- 16 months) underwent a bidirectional cavopulmonary shunt procedure with fine adjustment of additional pulmonary blood flow, as an intermediate step before the Fontan operation. The...

We have produced an eccentric roller type total artificial heart (ERTAH). As the first step in the development of this ERTAH, we conducted simulations such as a numerical simulation, a mock test, and an acute animal experiment using DeBakey roller pumps to analyze the left-right balance during its operation. The next step was redesigning the blood chambers to improve energy efficiency and impla...

BACKGROUND Right to left shunting, usually caused by a patent foramen ovale (PFO), is associated with migraine and visual aura. It is unknown if patients who present with visual aura without headache behave similarly to those experiencing typical migraine headache with aura. The purpose of this study was to assess the prevalence of right to left shunting in patients who present with migraine au...

A 76-year-old woman with a history of aortic valve replacement was referred for echocardiography for routine postoperative evaluation. Transthoracic echocardiogram revealed evidence of an intracardiac shunt between the left ventricle (LV) and the right atrium (RA) (Figure 1A). A transesophageal echocardiogram confirmed the presence of an LV to RA shunt consistent with a Gerbode defect (Figure 1...

This report presents a new, simple and reliable method of quantitating left-to-right shunts from arterial dilution surves. When indicatior (e,g., indocyanine green) is injected centrally (right venticle or pulmonary artery) and blood is withdrawn rapidly from either the aorta or other central systemic artery, in the presence of a left-to-right shunt to recorded indicator-dilution curve usually ...

Objective: The authors report a rare case of giant thoracic meningocele causing acute respiratory compromise, treated with a ventriculoperitoneal shunt. Case Report: We report the case of a 36-year-old with severe scoliosis status post repair over a decade ago, neurofibromatosis type I, and a known large meningocele in the left thoracic cavity, presenting with new acute respiratory compromise. ...

Eisenmenger’s syndrome is defined as the process in which a left-to-right shunt caused by a congenital heart defect causes increased flow through the pulmonary vasculature, causing pulmonary hypertension which causes increased pressures in the right side of the heart and reversal of the shunt into a right-to-left shunt. It can occur with complex congenital cardiac malformations, septal defects,...