title: Percutaneous control of a portacaval H-graft: description of a new device and its initial clinical application.
abstract: A percutaneously-controlled inflatable cuff which can change the diameter of a portacaval H-graft has been developed and used in 10 patients. When inflated, the cuff narrows the H-graft to increase portal pressure and reduce shunting. Use of the cuff has been of clinical significance in 3 of 7 long-term surviving patients. Narrowing the shunt improved the clinical state in 2 patients with encephalopathy, and reopening a closed shunt improved ascites in the third patient. Duplex ultrasound and deep Doppler have demonstrated an alteration of hepatic portal blood flow following inflation of the cuff after 6 months. It is concluded that further development of this controlled portacaval H-graft is warranted.
authors.affiliation: Department of Surgery, University of Sydney, Royal North Shore Hospital, Australia.
authors.forename: R C
authors.initials: RC
authors.lastname: Smith
authors.forename: A R
authors.initials: AR
authors.lastname: Brown
authors.forename: P C
authors.initials: PC
authors.lastname: Spencer
authors.forename: R W
authors.initials: RW
authors.lastname: Gill
authors.forename: K A
authors.initials: KA
authors.lastname: Griffiths
authors.forename: R J
authors.initials: RJ
authors.lastname: Lane
authors.forename: T S
authors.initials: TS
authors.lastname: Reeve
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006501:Hepatic Encephalopathy / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011170:Portasystemic Shunt, Surgical / Q000295:instrumentation* / Q000379:methods
chemical_list: D011138:Polytetrafluoroethylene