title: Atrial septal perforation from TIPS stent migration.
abstract: Transjugular intrahepatic portosystemic shunts (TIPS) are safe and effective for the treatment of portal hypertension. Cardiac complications are unusual. This study reports a case of TIPS stent migration to the right atrium causing perforation of the atrial septum in a patient with end-stage liver disease. The shunt was removed transvenously but attempts at transvenous occlusion of the septal perforation were unsuccessful. The patient went on to undergo combined open-heart surgery with septum repair and liver transplantation. The case highlights a rare complication of TIPS and methods for treatment including transvenous removal, transvenous repair, and combined cardiotomy-liver transplantation surgery.
authors.affiliation: Division of Gastroenterology, Department of Transplant Surgery, University of Colorado Health Sciences Center, Denver, Colorado, USA. hayaship@slu.edu
authors.forename: Paul H
authors.initials: PH
authors.lastname: Hayashi
authors.forename: Jae
authors.initials: J
authors.lastname: Mao
authors.forename: Kellee
authors.initials: K
authors.lastname: Slater
authors.forename: Robert
authors.initials: R
authors.lastname: Liao
authors.forename: Janette D
authors.initials: JD
authors.lastname: Durham
authors.forename: John
authors.initials: J
authors.lastname: Carroll
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Everson
authors.forename: Igal
authors.initials: I
authors.lastname: Kam
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Forman
mesh_terms: D000328:Adult; D004452:Echocardiography; D005548:Foreign-Body Migration / Q000150:complications* / Q000000981:diagnostic imaging; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D008297:Male; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D015641:Radiography, Interventional; D015607:Stents