Mesoatrial shunt in Budd-Chiari syndrome

• Published in: The American journal of surgery Vol. 179; no. 4; pp. 304 - 308
• Main Authors: Emre, Ali, Kalaycı, Göksel, Özden, İlgin, Bilge, Orhan, Acarlı, Koray, Kaymakoğlu, Sabahattin, Rozanes, İzzet, Ökten, Atilla, Tekant, Yaman, Alper, Aydın, Arıoğul, Orhan
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2000; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Anticoagulants; Ascites; Biological and medical sciences; Biopsy; Blood clots; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - methods; Budd-Chiari Syndrome - diagnosis; Budd-Chiari Syndrome - surgery; Chronic Disease; Diuretics; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Heart Atria - surgery; Humans; Laparotomy; Liver cirrhosis; Liver transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical imaging; Medical sciences; Mesenteric Veins - surgery; Ostomy; Other diseases. Semiology; Patients; Polytetrafluoroethylene; Portasystemic Shunt, Surgical - methods; Shunts; Stenosis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Thromboembolism; Thrombosis; Time Factors; Transplantation; Ulcers; Ultrasonic imaging; Veins & arteries; Vena Cava, Inferior - surgery; Vena Cava, Superior - surgery; Human; Portal circulation disease; Shunt; Liver; Cardiovascular disease; Transplantation; Venous disease; Result; Vascular disease; Treatment; Surgery; Budd Chiari syndrome; Digestive diseases; Technique
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(00)00335-4

Background: The operations with proven effects on survival in Budd-Chiari syndrome are shunt operations and liver transplantation. Patients and methods: Between 1993 and 1999 (June), 13 cases of Budd-Chiari syndrome have been treated surgically. Four cases had concomitant thrombosis of the inferior vena cava; the others had marked narrowing of the lumen due to the enlarged caudate lobe. Mesoatrial (n = 12) or mesosuperior vena caval (n = 1) shunts were constructed with ringed polytetrafluoroethylene grafts. Results: The median portal pressure fell from 45 (range 32 to 55) to 20 (range 11 to 27) cm H 2O ( P <0.001). Two patients died in the early postoperative period. One patient who did not comply with anticoagulant treatment had a shunt thrombosis in the second postoperative year. The other 10 patients are alive without problems during a median 42 (range 1 to 76) months of follow-up. Conclusion: Mesoatrial shunt with a ringed polytetrafluoroethylene graft is effective in Budd-Chiari syndrome cases with thrombosis or significant stenosis in the inferior vena cava.