J.Jpn. Surg. Soc.. 83(2): 239-243, 1982
Original article
MESOATRIAL SHUNT, A PROCEDURE FOR COMBINED VENA CAVA AND HEPATIC VEIN OCCLUSION
|
Department of Cardiovascular Surgery, National Cardiovascular Center Nobuyuki Nakajima, Ikuo Adachi, Yoshiharu Takahara, Yoichi Ego, Tsuyoshi Fujita |
The venographic study at this time revealed occlusion of deep venous system of legs and inferior vena cava below the level of opening of hepatic vein. He finally developed hepatic dysfunction and marked accumulation of ascites. Portography confirmed the diagnosis of occlusion of hepatic vein. Also inferior vena cava was found to be totally obstructed. The initial schedule of insertion of peritoneojugular shunt (Le Veen's shunt) was abandoned because of a episode of massive hemorrhage from esophageal varices. Mesoatrial shunt was created by using 12mm double velour dacron graft.
Postoperatively, marked hemodynamic improvement was observed. Ascites was completely disappeared. The prominent co-lateral circulation with dilated veins of abdominal wall as well as swelling of bilateral legs were reduced. Deterioration of liver function by this procedure was not observed. Patient showed uneventful recovery when he developed fulminate sepsis, probably due to the complication of steroid treatment and died at 45 days after surgery.
The shunt was functioned well till to the end.
To read the PDF file you will need Adobe Reader installed on your computer.