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A Thomas Pezzella
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Asian Cardiovasc Thorac Ann 1999;7:287-291
© 1999 Asia Publishing EXchange Pte Ltd

ORIGINAL CONTRIBUTION

Intracardiac Right-to-Left Shunt Complicating Right Ventricular Failure

Hasanat Sharif, MD, A Thomas Pezzella, MD, Husam H Farah, MD,1, Raj Baljepally, MD,1, Dennis Maki, MD,1

Division of Cardiac Surgery
1 Division of Cardiology
St. Vincent Hospital
Worcester, Massachusetts, USA
For reprint information contact: A Thomas Pezzella, MD Tel: 1 508 798 6318 Fax: 1 508 798 1621 email: thomas.pezzella{at}banyan.ummed.edu Division of Cardiac Surgery, St. Vincent Hospital, 25 Winthrop Street, Worcester, MA 01604, USA.
Three cases of intracardiac right-to-left shunt at the atrial level complicating right ventricular failure (RV) are described. Severe hypoxemia resulted in 2 patients and stroke in the third. This was a consequence of right ventricular infarction causing right-sided heart failure resulting in high right-sided pressures. Echocardiography demonstrated the shunts. A review of the literature on this uncommon problem suggested management strategies based on the limited experience with this condition.




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