Advances and new concepts in the designing of peritoneovenous shunts for the treatment of refractory ascites.
From August 1984 to December 1987, 10 patients received the Minnesota peritoneovenous shunt at our institution. Four of these patients previously had received seven Denver catheters with clinical and/or radiologic evidence of malfunction. Eight patients had the diagnosis of benign intractable ascites and two malignant ascites. In two hypercoagulable patients re-exploration of the intravascular limbs was necessary for fibrin plugging, but in no case have we seen catheter tip blood clot thrombosis. One shunt failed to work properly because of adhesions. At present, six of these patients are alive with a functioning shunt and four have died of nonshunt-related complications. The longest period of continuous function with a Minnesota shunt was 100 weeks. Data from this trial are compared retrospectively with data from patients who received LeVeen (n = 8) or Denver shunts (n = 7) at the University of Minnesota Hospitals during the same time period. Performance of the Minnesota shunt was comparable to the commercially available LeVeen and Denver shunts in most respects and appeared to offer advantages in longer functional life and reduction of intensive care unit admissions.
Guzman
E
E
Department of Surgery, University of Minnesota, Minneapolis 55455.
Wigness
B D
BD
Dorman
F D
FD
Rohde
T D
TD
Buchwald
H
H
D001201:Ascites / Q000628:therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D008875:Middle Aged; D010536:Peritoneovenous Shunt; D011474:Prosthesis Design; D012189:Retrospective Studies