right-to-left shunt

右左シャント

WordNet

1. toward or on the right; also used figuratively; "he looked right and left"; "the party has moved right"
2. (frequently plural) the interest possessed by law or custom in some intangible thing; "mineral rights"; "film rights"
3. anything in accord with principles of justice; "he feels he is in the right"; "the rightfulness of his claim" (同)rightfulness
4. a turn toward the side of the body that is on the south when the person is facing east; "take a right at the corner"
5. the hand that is on the right side of the body; "he writes with his right hand but pitches with his left"; "hit him with quick rights to the body" (同)right_hand
6. those who support political or social or economic conservatism; those who believe that things are better left unchanged (同)right wing
7. an abstract idea of that which is due to a person or governmental body by law or tradition or nature; "they are endowed by their Creator with certain unalienable Rights"; "Certain rights can never be granted to the government but must be kept in the hands
8. location near or direction toward the right side; i.e. the side to the south when a person or object faces east; "he stood on the right"
9. make reparations or amends for; "right a wrongs done to the victims of the Holocaust" (同)compensate, redress, correct
10. correct in opinion or judgment; "time proved him right" (同)correct
11. exactly; "he fell flop on his face" (同)flop
12. an interjection expressing agreement (同)right on
13. intended for the right hand; "a right-hand glove" (同)right-hand
14. (of the side of cloth or clothing) facing or intended to face outward; "the right side of the cloth showed the pattern"; "be sure your shirt is right side out"
15. being or located on or directed toward the side of the body to the east when facing north; "my right hand"; "right center field"; "a right-hand turn"; "the right bank of a river is the bank on your right side when you are facing downstream"
16. completely; "she felt right at home"; "he fell right into the trap"
17. having the axis perpendicular to the base; "a right angle"
18. immediately; "she called right after dinner"
19. in conformance with justice or law or morality; "do the right thing and confess"
20. in or into a satisfactory condition; "things are right again now"; "put things right"
21. of or belonging to the political or intellectual right
22. precisely, exactly; "stand right here!"
23. put in or restore to an upright position; "They righted the sailboat that had capsized"
24. regain an upright or proper position; "The capsized boat righted again"
25. toward or on the left; also used figuratively; "he looked right and left"; "the political party has moved left"
26. a turn toward the side of the body that is on the north when the person is facing east; "take a left at the corner"
27. the hand that is on the left side of the body; "jab with your left" (同)left_hand
28. those who support varying degrees of social or political or economic change designed to promote the public welfare (同)left wing
29. location near or direction toward the left side; i.e. the side to the north when a person or object faces east; "she stood on the left"
30. intended for the left hand; "I rarely lose a left-hand glove" (同)left-hand
31. being or located on or directed toward the side of the body to the west when facing north; "my left hand"; "left center field"; "the left bank of a river is bank on your left side when you are facing downstream"
32. of or belonging to the political or intellectual left
33. connect or secure to; "They rigged the bomb to the ignition"
34. formation of masts, spars, sails, etc., on a vessel (同)rigging
35. gear (including necessary machinery) for a particular enterprise
36. manipulate in a fraudulent manner; "rig prices" (同)manipulate
37. arrange the outcome of by means of deceit; "rig an election" (同)set_up
38. equip with sails or masts; "rig a ship" (同)set, set_up
39. transfer to another track, of trains
40. a conductor having low resistance in parallel with another device to divert a fraction of the current (同)electrical shunt, bypass
41. implant consisting of a tube made of plastic or rubber; for draining fluids within the body
42. a passage by which a bodily fluid (especially blood) is diverted from one channel to another; "an arteriovenus shunt"
43. provide with or divert by means of an electrical shunt

PrepTutorEJDIC

1. 《名試の前にのみ用いて》『右の』,右側の / 《しばしば『R-』》(政治上)『右派の』,保守的な / 〈U〉《the~》『右』,右側,右方 / 〈C〉『右手』(right hand) / 〈U〉《集合的に》《しばしばthe R-》(政治上の)右派,保守派 / 〈C〉(野球の)右翼(right field) / 『右に』,右側に,右方に
2. 《補語にのみ用いて》(道徳的に)『正しい』,正当な,正義の(just) / (人,人の判断・意見などが)『間偉いのない』,正しい(correct) / (事実に合って)『正しい』,正確な / 適切な,ぴったりの / (精神が)健全な,まともな;(心身が)健康な / 表の,正面の / 〈U〉(道徳的な)『正しさ』,正義;正しい行い / 〈C〉〈U〉(法律上・道徳上の)権利 / 〈U〉〈C〉《複数形で》(政治的・社会的な)人権,権利 / 《話》『まっすぐに』;まともに(directly) / 《話》『きっかり』,ちょうど(exactly) / 正確に,間違いなく(correctly) / (道徳的に)正しく,公正に / すっかり,完全に(completely);ずっと(all the way) / 適切に,ふさわしく;都合よく,うまく / 《おもに米話》すぐに,ただちに / 《特定の称号に付けて》非常に(very) / …‘を'正しい位置(状態)に戻す,立ち直らせる,整とんする / 〈誤りなど〉‘を'正す
3. leaveの過去・過去分詞
4. 《名詞の前にのみ用いて》『左の』,左方の / 《しばしばl-》(政治上の)左翼の,左派の,革新派の / 左に,左方に / 《通例 the ~》『左』,左方,左側 / 《しばしばthe L-》左翼の政党(団体),左派 / 〈U〉(野球で)左翼,レフト(left field);〈C〉左翼手(left fielder) / 〈C〉(ボクシングで)左手打ち
5. 〈船〉‘を'艤装(ぎそう)する / (マストなどを)〈船〉‘に'つける《+『名』+『with』+『名』》;(マストに)〈帆〉‘を'つける《+『名』+『to』+『名』》 / …‘に'装備をつける;…‘を'装備する《+『up』+『名,』+『名』+『up』》 / 船の装備(帆装),艤装(ぎそう) / (特定の目的のための)道具,用具 / 《英話》衣服,服装(clothing)
6. 〈他〉〈相場など〉を不正な手段であやつる
7. 《方向》(1)(到着の意を含めて)…『へ』,に,まで / 《状況の変化》…[のほう]へ;…に[なるまで],その結果…になる / 《適用範囲》(1)《動詞に伴って》『…に対して』,に,へ / (2)《形容詞[句]・[代]名倍に伴って》『…に対して』 / 《程度・範囲》『…[に至る]まで』 / 《時間の終り》『…まで』(till) / 《to one's+『名』の形で》(…が)『…したことに[は]』 / 《比較・対比・割合》『…と比べて』,より,に対して / 《一致・適合》『…に合わせて』,に合って,に応じて / 《目的・意図》『…のために』 / 《運命・境遇》『…に』 / 《所属・関係》『…へ』,に[対して] / 《付加・付着・固執》『…に』 / 《対立・対向》…に[対して] / いつもの状態(位置)に / 停止(閉鎖)の状態に / 活動状態に(へ),仕事に
8. 《名詞的用法》『…すること』 / 《形容詞的用法》『…するための,すべき』 / 《副詞的用法》『…するために』,して,するとは,すれば / 《独立用法》 / 《文全体を修飾する慣用語句》…すれば,してみると,…だが / 短縮文
9. 〈人・物〉‘を'わきにどかす;〈話題など〉‘を'他へそらす / (別の軌道に)〈車両〉‘を'入れ換える / 〈電流〉‘を'わきへそらす;〈分路〉‘を'置く / わきへそれる / 〈車両が〉分岐線に移行する / 〈U〉わきへそれること / 〈C〉転てつ器;(電気の)分路

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/17 15:39:36」(JST)

wiki en

[Wiki en表示]

A right-to-left shunt is a cardiac shunt which allows blood to flow from the right heart to the left heart. This terminology is used both for the abnormal state in humans and for normal physiological shunts in reptiles.

Clinical Significance

A right-to-left shunt occurs when:

1. there is an opening or passage between the atria, ventricles, and/or great vessels; and,
2. right heart pressure is higher than left heart pressure and/or the shunt has a one-way valvular opening.

Small physiological, or "normal", shunts are seen due to the return of bronchial artery blood and coronary blood through the Thebesian veins, which is deoxygenated, to the left side of the heart.

Causes

Congenital defects can lead to right-to-left shunting immediately after birth:

• Persistent truncus arteriosus (minimal cyanosis)
• Transposition of great vessels
• Tricuspid atresia
• Tetralogy of Fallot
• Total anomalous pulmonary venous return

A mainstem intubation with an endotracheal tube can lead to right-to-left shunting. This occurs when the tip of the endotracheal tube is placed beyond the carina. In this way only one lung is oxygenated and oxygen-poor blood from the non-ventilated lung dilutes the oxygen level of blood returning from the lungs in the left ventricle.

Eisenmenger syndrome

An uncorrected left-to-right shunt can progress to a right-to-left shunt; this process is termed Eisenmenger syndrome. This is seen in Ventricular septal defect, Atrial septal defect, and patent ductus arteriosus, and can manifest as late as adult life. This switch in blood flow direction is precipitated by pulmonary hypertension due to increased pulmonary blood flow in a left-to-right shunt. The right ventricle hypertrophies to compensate for this pulmonary hypertension, so the right ventricular pressure becomes higher than the pressure in the left ventricle. Because of this switch in the pressure gradient, blood starts flowing right to left, forming a right-to-left shunt. As with any right-to-left shunt, there is decreased blood flow to the lungs, resulting in decreased oxygenation of blood and cyanosis.

Tetralogy of Fallot

The most common cause of right-to-left shunt is the Tetralogy of Fallot, a congenital cardiac anomaly characterized by four co-existing heart defects.

1. Pulmonary stenosis (narrowing of the pulmonary valve and outflow tract, obstructing blood flow from the right ventricle to the pulmonary artery)
2. Overriding aorta (aortic valve is enlarged and appears to arise from both the left and right ventricles instead of the left ventricle, as occurs in normal hearts)
3. Right ventricular hypertrophy (thickening of the muscular walls of the right ventricle, this is a result of the increased amount of work the heart has to do)
4. Ventricular septal defect (a hole exists in the septum that divides the left and right ventricles)

Symptoms

Early cyanosis is a symptom of a right-to-left shunt. A right-to-left shunt results in decreased blood flow through the pulmonary system, leading to decreased blood oxygen levels (hypoxemia). Hypoxemia manifests as cyanosis, or "blue babies."

Diagnosis

Differentiation between a right-to-left shunt and pulmonary disease is often aided clinically by the results of a hyperoxia test. Using high levels of inspired oxygen should have little effect on the dissolved O2 in the blood because highly oxygenated blood is diluted by shunted (low oxygenation) blood.

Shunt equation

• Qs/Qt is the shunt fraction
• CcO2 is the end-capillary oxygen content
• CaO2 is the arterial oxygen content
• CvO2 is the mixed venous oxygen content.

Reptiles

See also: Reptile § Circulation

Because most reptiles have a single ventricle and all reptiles have both a right aortic arch and a left aortic arch, all reptiles have the capacity for right-to-left shunt.

References

UpToDate Contents

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• 1. 低酸素血症の酸素供給およびメカニズム oxygenation and mechanisms of hypoxemia
• 2. 成人における心房中隔異常（PFO、ASD、およびASA）および脳塞栓症のリスク atrial septal abnormalities pfo asd and asa and risk of cerebral emboli in adults
• 3. 新生児におけるチアノーゼの概要 overview of cyanosis in the newborn
• 4. Eisenmenger症候群の評価および予後 evaluation and prognosis of eisenmenger syndrome
• 5. 卵円孔開存 patent foramen ovale

English Journal

• Right-to-left shunt detection sensitivity with air-saline and air-succinil gelatin transcranial Doppler.

• Puledda F1, Toscano M1, Pieroni A1, Veneroso G2, Di Piero V1, Vicenzini E3.
• International journal of stroke : official journal of the International Stroke Society.Int J Stroke.2016 Feb;11(2):229-38. doi: 10.1177/1747493015609938.
• BACKGROUND: Air-saline transcranial Doppler is nowadays the first-choice examination to identify right-to-left shunt. To increase right-to-left shunt detection in echocardiography, cardiologists also use air-gelatin mixtures, which are more stable, more echogenic, and easier to be prepared.AIM: We a
• PMID 26783315

• Intracardiac Right-to-Left Shunt Impeding Liberation From Veno-Venous Extracorporeal Membrane Oxygenation: Two Case Studies.

• Gillon SA1, Barrett NA, Ioannou N, Camporota L, Victor K, Gowland A, Meadows CI, Langrish C, Tricklebank S, Wyncoll D.
• Critical care medicine.Crit Care Med.2016 Jan 20. [Epub ahead of print]
• OBJECTIVES: Veno-venous extracorporeal membrane oxygenation is an increasingly used form of advanced respiratory support, but its effects on the physiology of the right heart are incompletely understood. We seek to illustrate the impact of veno-venous extracorporeal membrane oxygenation return blood
• PMID 26807685

• High-Output Heart Failure from a Hepatic Hemangioma With Exertion-Induced Hypoxia.

• Smith AA1, Nelson M2.
• The American journal of cardiology.Am J Cardiol.2016 Jan 1;117(1):157-8. doi: 10.1016/j.amjcard.2015.10.019. Epub 2015 Oct 19.
• Patients with hepatic hemangiomas have been known to have high-output heart failure as a result of left-to-right arteriovenous shunting. We report a patient with a hepatic hemangioma that presented with high-output heart failure with hypoxia on exertion. After embolization of the hemangioma, the pat
• PMID 26525213

Japanese Journal

• Embolization of Pulmonary Arteriovenous Malformations : Outcomes and Long-term Follow up in 10 Patients with Hereditary Hemorrhagic Telangiectasia

• Sato Kazuhiro,Shioya Takanobu,Asano Mariko [他],Okuda Yuji,Miura Hajime,Sano Masaaki,Iino Kenji,Kosaka Toshimitsu,Watanabe Hiroyuki,Hashimoto Manabu,Ito Hiroshi
• 秋田医学 40(1), 13-21, 2013-06-28
• … Purpose : To evaluate the efficacy of embolotherapy in oxygenation and event-free survival, even with persistent untreated small PAVMs. … We evaluated improvement in partial arterial oxygen pressure (PaO2) and right-to-left shunt and followed up the prevalence of long-term complications after embolotherapy. …
• NAID 110009598157

• 症例 経頭蓋超音波にて右左シャントを確認しえた脳膿瘍を合併した肺動静脈奇形の1例

• 高倉 裕樹,濱中 伸介,今坂 圭介 [他]
• 日本呼吸器学会誌 = Annals of the Japanese Respiratory Society 2(3), 254-258, 2013-05-10
• NAID 40019737274

• 腕頭動脈可動性プラークの評価にリアルタイム3次元経食道心臓超音波検査が有用であった1例

• 田中 弘二,斎藤 こずえ,佐藤 和明,土井尻 遼介,大塚 伸子,古賀 政利,豊田 一則,長束 一行
• Neurosonology:神経超音波医学 25(3), 148-152, 2013
• … An 85 year-old woman with hypertension and dyslipidemia was admitted with visual impairment, left hemiparesis, and sensory disturbance. … Magnetic resonance imaging revealed a fresh infarct in the right occipital lobe and magnetic resonance angiography (MRA) showed occlusion of the right posterior cerebral artery (PCA). …
• NAID 130003366434

Related Links

• Right-to-left shunt | Define Right-to-left shunt at Dictionary.com

Medical Dictionary right-to-left shunt n. The passage of blood from the right side of the heart into the left, as through a septal defect. The passage of blood from the pulmonary artery into the aorta, as through a patent ductus arteriosus.

• right-to-left shunt - definition of right-to-left shunt in the ...

the passage of blood from the right side of the heart into the left (as through a septal defect), or from the pulmonary artery into the aorta (as through a patent ductus arteriosus); such a shunt can occur only when the pressure on the ...

Related Pictures

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★リンクテーブル★

リンク元	「右-左短絡」「左右短絡」
関連記事	「right」「left」「ting」「shunt」「toed」

「右-左短絡」

　　[★]

英

right-to-left shunt

同

右-左シャント

関

逆短絡

「左右短絡」

　　[★]

英

right-to-left shunt

関

左右シャント

「right」

　　[★]

• n.

• 右、権利

• adj.

• 正しい、右位の、直角の

関

correct、dexter、dextroposition、fair、human right、rectangular、right angle

　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　

「left」

　　[★]

• adj.

• 左の、左方の

• n.

• 左、

• v.

• (leaveの過去-過去分詞として)去る

関

leave

　 　 　 　 　 　 　 　 　 　

「ting」

　　[★]

• vi.

• (鈴などが)チリンチリンと鳴る

• vt.

• (鈴などを)チリンチリンと鳴らす

• n.

• (鈴などの)チリンチリンと鳴る音

「shunt」

　　[★]

• vt.

• ～をそらす

• n.

• 短絡、分路、(医療)吻合術、シャント、

→シャント

　 　 　 　 　 　

「toed」

　　[★]

• adj.

• 足指のある、つま先のある、(くぎを)斜めに打ち込んだ