Open AccessHemodynamic Guidelines for Surgical Therapy of Portal Hypertension
Author(s) -
Harvey A. Koolpe,
W Embil,
L Koolpe,
Edward Russell,
Chad Williams
Publication year - 1981
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198111000-00002
Subject(s) - medicine , cirrhosis , hemodynamics , cardiology , portal hypertension , alcoholic liver disease , pulmonary wedge pressure , portal venous pressure , inferior vena cava , shunt (medical) , blood pressure , surgery
A prospective study of 98 patients with portal hypertension who hemorrhaged revealed that certain hemodynamic parameters were valuable in confirming the cause of cirrhosis, aiding in the selection of patients best suited for a selective distal splenorenal shunt, and in providing an estimate of prognosis. The presence of a pressure gradient of 4 mmHg or more between the right atrium and inferior vena cava was observed only in patients with alcoholic cirrhosis. The shape of the "pull-back" tracing between the wedge and free hepatic vein positions was "smooth" in postnecrotic disease and "lumpy" in alcoholic disease. The ratio of the aortic diastolic pressure divided by the hepatic (vein) wedge pressure segregated patients by cause and direction of portal blood flow.