title: Mesoatrial shunt in Budd-Chiari syndrome.
abstract: 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.
authors.affiliation: Department of General Surgery, Hepatopancreatobiliary Surgery Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Emre
authors.forename: G
authors.initials: G
authors.lastname: Kalayci
authors.forename: I
authors.initials: I
authors.lastname: Ozden
authors.forename: O
authors.initials: O
authors.lastname: Bilge
authors.forename: K
authors.initials: K
authors.lastname: Acarli
authors.forename: S
authors.initials: S
authors.lastname: Kaymakoğlu
authors.forename: I
authors.initials: I
authors.lastname: Rozanes
authors.forename: A
authors.initials: A
authors.lastname: Okten
authors.forename: Y
authors.initials: Y
authors.lastname: Tekant
authors.forename: A
authors.initials: A
authors.lastname: Alper
authors.forename: O
authors.initials: O
authors.lastname: Arioğul
mesh_terms: 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*
chemical_list: D011138:Polytetrafluoroethylene