Successful liver transplantation in an adult residual atrial septal defect and left-to-right shunt

A case of orthotopic liver transplantation performed in an adult, presenting postviral C cirrhosis and a residual atrial septal defect, is reported. This defect was responsible for a left-to-right shunt and moderate systolic pulmonary hypertension. Liver transplantation was done using an inferior vena cava preservation technique with a latero-lateral cavo-caval anastomosis and without veno-venous bypass in order to minimally interfere with the haemodynamic condition. This case report shows that adaptation of surgical technique may allow successful liver transplantation in cases of haemodynamically significant atrial septal defects.