title: High-output congestive heart failure following transjugular intrahepatic portal-systemic shunting.
abstract: 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.
authors.affiliation: Cardiovascular Division, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Braverman
authors.forename: M A
authors.initials: MA
authors.lastname: Steiner
authors.forename: D
authors.initials: D
authors.lastname: Picus
authors.forename: H
authors.initials: H
authors.lastname: White
mesh_terms: 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