Open AccessPredictability and Maintenance of Portal Flow Patterns After Small-Diameter Portacaval H-Grafts in Man
Author(s) -
Eric B. Rypins,
Gary L. Mason,
Robert M. Conroy,
I. James Sarfeh
Publication year - 1984
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 - 10.1097/00000658-198412000-00006
Subject(s) - medicine , portacaval shunt , shunt (medical) , portography , encephalopathy , portal vein , surgery , portal vein thrombosis , portal hypertension , perfusion , radiology , cirrhosis
Patients undergoing small-diameter (8, 10, 12, and 14 mm) portacaval H-grafts were followed up to 3.5 years. Eight- and 10-mm grafts maintained prograde portal perfusion in 50% of the patients. Follow-up studies performed from 6 to 36 months after surgery show late shunt patency to be 97%. Recurrent variceal hemorrhage has not occurred in any patients. Direction of portal flow after a shunt was related to the size of the portal vein and the size of the shunt. If the shunt diameter was less than 50% that of the portal vein measured on the preoperative angiogram, portal flow was prograde. Encephalopathy rates remained significantly lower in patients with prograde flow after small diameter (8 and 10 mm) portacaval H-graft (p = .0.1). If thrombosis and encephalopathy rates remain low, the small-diameter, polytetrafluoroethylene portacaval H-graft is an attractive alternative to standard portacaval and mesocaval shunts.