23 Sep

Intrapulmonary Vascular Dilatations (IPVD) in Liver Transplant Candidates: Discussion (Part 4)

During inspiration, these vessels were found to dilate significantly. Corner vessels were thought to function as a potential arteriovenous anastomosis in that venous blood could flow through these channels during wide swings in alveolar pressure. Either of these situations, if present in humans, could be the source of microbubble passage through normal lung tissue in that the diameters of the extra-alveolar channels (200 mm) and corner vessels (50 mm) can be significant. Liver disease and its associated hemodynamic consequences could result in further shunting through such low resistance pathways with or without the interaction of other circulatory factors. Hence, positive CE echocardiography in the setting of normal Pa02 suggests the presence of vascular dilatations that may be of little clinical importance or perhaps not specific for liver disease. Get most advantageous deals offered to you by the pharmacy you are going to appreciate soon after you become its customer: you now can get your cialis professional canadian pharmacy online any time of the day or night with very fast delivery and quality guarantees.
What is the clinical utility of CE echocardiography in patients with advanced liver disease? From an academic perspective, it provides a noninvasive opportunity to study a spectrum of pulmonary vascular physiology known to complicate liver disease. Refinement of technique may result in the ability to quantitate or localize intrapulmonary shunting. Certainly additional study and comparison with other shunt imaging methods are needed.

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