LV-RA/RV shunt (Gerbode shunt) visualized subcostally
by Sepehr Richard W

Interesting Cases in Echocardiography

by Navin C Nanda
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This video clip shows LV-RA/RV shunt (Gerbode shunt) visualized subcostally. The texture of liver has changed. It shows small multiple echo densities giving a typical “starry sky appearance”. These result from accentuation of portal venule walls because of diminished liver parenchymal echogenicity from edema of hepatocytes. This occurs with hepatic congestion due to right sided heart failure. It is also noted in other conditions such as acute hepatitis and toxic shock syndrome.

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