A-V shunt

A-V shunt

(shŭnt),
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Cardiac ultrasonography revealed severe tricuspid regurgitation, but good motion of the bilateral ventricular walls with a left ventricular ejection fraction of 0.78, suggesting congestive heart failure due to increased venous return through the intrahepatic A-V shunts. Unexpectedly, she developed left hemiplegia and right conjugate deviation, and brain computed tomography showed a large fresh infarction of the right frontal lobe.
The periportal arterioles often communicated directly with the ectatic sinusoids, causing A-V shunts through the ectatic sinusoids (Figure 3, a and c).
This study has shown that the essential pathologic changes of the hepatic vasculature in patients with HHT are as follows: (1) focal sinusoidal ectasia, (2) abnormal direct communications between hepatic arteriolar branches and ectatic sinusoids (formation of A-V shunts), and (3) frequent and large communications between the portal and central veins through ectatic sinusoids (formation of P-V shunts).