Clinical Implications of Pulmonary Shunting on Contrast Echocardiography

Cure HHT provided financial support for the publication of Dr. Sebastian Velthuis‘ thesis which focused on the diagnosis and clinical implications of pulmonary arteriovenous malformations (PAVMs) in HHT. Due to the high prevalence of PAVMs, its potential severe complications and effective treatment options, screening for PAVMs is recommended in all persons with possible or confirmed HHT. This screening was traditionally perfomred by chest CT, but has been replaced by transthroacic contrast echocardiography (TTCE). Depending on the number of contrast microbubbles counted in one still fram of the left-sided heart chamber, a pulmanry shunt is graded 1 (maximum of 29 microbubbles), 2 (30-100 microbubbles), 3 (>100 microbubbles). The aim of Dr. Velthuis’ thesis was to further investigate the clinical implications of different shunt grades on TTCE in (suspected) HHT.