Hepato-pulmonary shunts

Hepato-pulmonary shunts might develop in some patients with severe liver disease, usually when cirrhosis has developed. At this stage, a dilatation of intra-pulmonary vessels might develop causing defects in blood oxygenation. Shortness of breath is a common symptom. The disease might be asymptomatic but it has an impact of patient's quality of life. The identification of shunt dysfunction is based on the arterial blood gas test. The dilatation of pulmonary vessels and shunting index can be identified by macro aggregated albumin lung perfusion scintigraphy (99mTc-MAA) or a transthoracic contrast-enhanced echocardiography.