Mesoatrial shunt in Budd-Chiari syndrome.
BACKGROUND
The operations with proven effects on survival in Budd-Chiari syndrome are shunt operations and liver transplantation.


METHODS
Between 1993 and 1999 (June), 13 cases of Budd-Chiari syndrome have been treated surgically. Four cases had concomitant thrombosis of the inferior vena cava; the others had marked narrowing of the lumen due to the enlarged caudate lobe. Mesoatrial (n = 12) or mesosuperior vena caval (n = 1) shunts were constructed with ringed polytetrafluoroethylene grafts.


RESULTS
The median portal pressure fell from 45 (range 32 to 55) to 20 (range 11 to 27) cm H(2)O (P <0.001). Two patients died in the early postoperative period. One patient who did not comply with anticoagulant treatment had a shunt thrombosis in the second postoperative year. The other 10 patients are alive without problems during a median 42 (range 1 to 76) months of follow-up.


CONCLUSIONS
Mesoatrial shunt with a ringed polytetrafluoroethylene graft is effective in Budd-Chiari syndrome cases with thrombosis or significant stenosis in the inferior vena cava.
Emre
A
A
Department of General Surgery, Hepatopancreatobiliary Surgery Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Kalayci
G
G
Ozden
I
I
Bilge
O
O
Acarli
K
K
Kaymakoğlu
S
S
Rozanes
I
I
Okten
A
A
Tekant
Y
Y
Alper
A
A
Arioğul
O
O
D000293:Adolescent; D000328:Adult; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D006502:Budd-Chiari Syndrome / Q000175:diagnosis / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D011138:Polytetrafluoroethylene; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D013997:Time Factors; D014682:Vena Cava, Inferior / Q000601:surgery*; D014683:Vena Cava, Superior / Q000601:surgery*
D011138:Polytetrafluoroethylene