CASE REPORT
Year : 2023  |  Volume : 17  |  Issue : 1  |  Page : 77-79

Cause of profound hypoxemia following a bilateral bidirectional Glenn shunt: Clue suggested by agitated saline echo contrast


1 Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman
2 Department of Pediatric Cardiology, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman
3 Department of Cardiothoracic Surgery, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman

Correspondence Address:
Madan M Maddali
Senior Consultant in Anesthesia, National Heart Center, Royal Hospital, P. B.No: 1331, P.C: 111, Seeb, Muscat
Sultanate of Oman
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.sja_371_22

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Following a bilateral bidirectional Glenn shunt, a child had persistent hypoxemia. Agitated saline contrast injection into the jugular vein during transesophageal echocardiography displayed a rapid appearance of saline particles in the cardiac chambers suggesting the presence of pulmonary arteriovenous malformations. However, the clinical picture was not in agreement and an angiographic contrast injection during an immediate cardiac catheterization revealed the underlying pathology which was immediately corrected surgically.


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