Intraoperative management of liver transplant in a patient with an undiagnosed ventricular septal defect: A case report

Figure 1  Transthoracic echocardiography apical 4 chamber view showing a small peri membranous ventricular septal defect with a left to right shunt (orange arrow).

Figure 2  Continuity equation to calculate shunt fraction Qp:Qs using transesophageal echocardiography.

Figure 3 Transesophageal echocardiography mid esophageal long axis view. A: Continuous wave doppler to calculate shunt flow velocity across the ventricular septal defect; B: Air/debris from newly implanted liver in the right ventricle only; C: Unchanged direction of left to right shunt (orange arrow) post reperfusion.