Cardiac and Pulmonary Anatomical Shunt

Q: What are anatomic Pulmonary and Cardiac shunting?

Answer:  

Pulmonary anatomical shunting: The bronchial circulation provides oxygenation to the lung and is not oxygenated before it returns to the left heart. 

Cardiac anatomical shunting: Some blood flowing through some small cardiac veins empties back into the left heart without oxygenation.

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Further readings:

1. Cressoni M, Caironi P, Polli F, Carlesso E, Chiumello D, Cadringher P, Quintel M, Ranieri VM, Bugedo G, Gattinoni L. Anatomical and functional intrapulmonary shunt in acute respiratory distress syndrome. Crit Care Med. 2008 Mar;36(3):669-75. doi: 10.1097/01.CCM.0000300276.12074.E1. PMID: 18091555.

2. Tobler D, Greutmann M. Simple cardiac shunts in adults: atrial septal defects, ventricular septal defects, patent ductus arteriosus. Heart. 2020 Feb;106(4):307-314. doi: 10.1136/heartjnl-2019-314700. Epub 2020 Jan 7. PMID: 31911502.

3. Her C. Anatomical intrapulmonary shunt. Crit Care Med. 2008 Sep;36(9):2713; author reply 2714-5. doi: 10.1097/CCM.0b013e3181847321. PMID: 18728503.

4. Schmiel M, Ono M, Staehler H, Georgiev S, Burri M, Heinisch PP, Strbad M, Ewert P, Hager A, Hörer J. Impact of Anatomical Sub-types and Shunt Types on Aortopulmonary Collaterals in Hypoplastic Left Heart Syndrome. Semin Thorac Cardiovasc Surg. 2023 Winter;35(4):746-756. doi: 10.1053/j.semtcvs.2022.08.005. Epub 2022 Aug 23. PMID: 36007868.