Contrast echocardiography in the diagnosis of intrapulmonary vascular dilations in patients eligible for liver transplantation.
OBJECTIVE
To determine the importance of contrast echocardiography in the diagnosis of intrapulmonary vascular dilations (PVD) in patients with severe hepatic diseases, eligible for transplantation.


METHODS
Transthoracic echocardiography (TTE) with second harmonic imaging was performed in 76 patients, among them 32 patients were consecutively undergone to a transesophageal study (ETE). Echocardiographic contrast was obtained from microbubbles derived from the injection of agitated saline solution, in venous peripheral access. Abnormal presence of contrast in the left cardiac chambers was considered positive, with a delay of 4 to 6 cardiac cycles, after initial opacification of the right cardiac chambers.


RESULTS
PVD diagnosis was performed in 53.9% of the patients (41/76). Sensibility, specificity, positive predictive value, negative predictive value, and accuracy of the TTE in relation to the ETE was 75%, 100%, 100%, 80% and 87.5%, respectively. Echocardiography was positive in 37 (55.2%) of 67 nonhypoxemic patients, and in 4 (44.4%) hypoxemic ones. No cardiologic hemodynamic repercussions from intrapulmonary shunt were observed.


CONCLUSIONS
The contrast echocardiography is efficient, easy to be used, and safe in the search for and identification of intrapulmonary vascular alterations in patients eligible for hepatic transplantation.
Hospital de Base e Faculdade de Medicina de São José do Rio Preto, SP, Brazil. pavarino@cardiol.br
Paulo Roberto
PR
Pavarino
Hélio Augusto do Reis
HA
Corbucci
Carlos Henrique de
CH
Marchi
Paula Fernanda da
PF
Mata
Moacir Fernandes de
MF
Godoy
D000328:Adult; D002908:Chronic Disease; D003287:Contrast Media; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008297:Male; D014652:Vascular Diseases / Q000000981:diagnostic imaging*
D003287:Contrast Media