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Intracardiac Right-to-Left Shunt Complicating Right Ventricular Failure

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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