Liver and Echocardiography: Denver Shunt Thrombus

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Echocardiographic appearance of a Denver shunt in the superior vena cava.

Right atrial mass originating at a Denver shunt in the superior vena cava. Histology showed a fibrin thrombus with numerous aggregates of of embedded neutrophils.

Cross section of the thrombus in the superior vena cava.

Closeup of the same thrombus.

Denver shunt thrombus in the right atrium.

Gosse P, Guez S, Roudaut R, Deville C, Dallocchio M. reported a similar complication of the Le Veen shunt: a right atrial ventricular chamber pseudotumor.
(Clin Cardiol 1987 May;10(5):370-1)
A right atrial-ventricular chamber thrombus was discovered four years after insertion of a Le Veen shunt for treatment of refractory ascites. A two-dimensional echocardiogram, performed after the discovery of an isolated systolic murmur, demonstrated a tumorlike mass seated in both the right atrium and the right ventricle. The mass was surgically removed and histologic examination confirmed that it was a thrombus that developed at the tip of the catheter. The authors propose that two-dimensional echocardiography should be performed periodically for the survey of such intracardiac devices.

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