Reversal of intrapulmonary arteriovenous shunting detected by two-dimensional contrast-enhanced echocardiography after liver transplantation.
BACKGROUND
Intrapulmonary arteriovenous shunting (IPS), occasionally associated with advanced liver disease, may reverse after liver transplantation (LTx). Two-dimensional contrast-enhanced echocardiography, a convenient noninvasive study, has never been used to demonstrate disappearance of IPS after LTx.


METHODS
For an 8-month-old girl undergoing living-related LTx, two-dimensional contrast-enhanced echocardiography was performed with the microbubble injection. The opacification of the microbubble in the left heart emerging within 3-6 beats after detection in the right heart was compared with that in the right heart.


RESULTS
Microbubble opacification in the left heart was almost the same as that in the right heart (grade 3) shortly after LTx. However, the contrast in the left heart diminished (grade 1) as the respiratory condition improved and subsequently disappeared (grade 0).


CONCLUSIONS
Two-dimensional contrast-enhanced echocardiography may be a feasible noninvasive method to evaluate the degree of IPS in the peritransplant period and observe disappearance of IPS after LTx.
Hasegawa
T
T
Department of Pediatric Surgery, Osaka University, Medical School, Suita City, Japan. toshi@pedsurg.med.osaka-u.ac.jp
Kamiyama
M
M
Azuma
T
T
Sasaki
T
T
Okada
A
A
Miwatani
T
T
Matsushita
T
T
D001166:Arteriovenous Shunt, Surgical; D004452:Echocardiography; D005260:Female; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging; D010100:Oxygen / Q000032:analysis; D011650:Pulmonary Alveoli / Q000737:chemistry; D011651:Pulmonary Artery / Q000737:chemistry; D011859:Radiography
D010100:Oxygen