Clinical experience of transjugular intrahepatic portosystemic shunt (TIPS) and its effects on systemic hemodynamics

We performed TIPS (transjugular intrahepatic portosystemic shunt) in patients with intractable esophageal varices accompanied by repeated hematemesis or with refractory ascites for the purpose of portal venous decompression, and successfully obtained complete elimination of esophageal varices or a m...

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Bibliographic Details
Published inHepato-gastroenterology Vol. 51; no. 59; p. 1470
Main Authors Naritaka, Yoshihiko, Ogawa, Kenji, Shimakawa, Takeshi, Wagatsuma, Yoshihisa, Konno, Soichi, Katsube, Takao, Hamaguchi, Kanako, Hosokawa, Toshihiko
Format Journal Article
LanguageEnglish
Published Greece 01.09.2004
Subjects
Aged
Esophageal and Gastric Varices - physiopathology
Esophageal and Gastric Varices - surgery
Follow-Up Studies
Heart Failure - diagnosis
Heart Failure - physiopathology
Hemodynamics - physiology
Humans
Liver Cirrhosis - physiopathology
Liver Cirrhosis - surgery
Male
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic
Postoperative Complications - physiopathology
Risk Factors
Tomography, X-Ray Computed
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Summary:We performed TIPS (transjugular intrahepatic portosystemic shunt) in patients with intractable esophageal varices accompanied by repeated hematemesis or with refractory ascites for the purpose of portal venous decompression, and successfully obtained complete elimination of esophageal varices or a marked decrease in ascites. While TIPS caused no particular variations in mean blood pressure or heart rate, cardiac output increased markedly on the 2nd and 3rd postoperative days before declining on the 5th postoperative day. Along with this, right atrial pressure, pulmonary arterial pressure and pulmonary capillary wedge pressure also increased transiently. TIPS has the potential to become an established effectual therapy for intractable esophageal varices and refractory ascites. However, careful attention should be paid to its hemodynamic effects, including the occurrence of cardiac failure.
ISSN:0172-6390