High-output congestive heart failure following transjugular intrahepatic portal-systemic shunting.
A hyperdynamic circulatory state with elevated cardiac output, decreased peripheral vascular resistance, and sodium retention occurs in patients with portal cirrhosis. Surgical portal-systemic shunts and transjugular intrahepatic portal-systemic shunts (TIPS) have been shown to worsen the high-output state in these patients. However, clinical evidence of high-output congestive heart failure has been reported only rarely to complicate cirrhosis. We describe a patient who developed high-output congestive heart failure with markedly elevated filling pressures after TIPS and had complete resolution of heart failure after liver transplantation.
Braverman
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AC
Cardiovascular Division, Washington University School of Medicine, St. Louis, MO 63110, USA.
Steiner
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MA
Picus
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White
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H
D016534:Cardiac Output, High / Q000209:etiology*; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects* / Q000379:methods