Atrial septal perforation from TIPS stent migration.
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.
Hayashi
Paul H
PH
Division of Gastroenterology, Department of Transplant Surgery, University of Colorado Health Sciences Center, Denver, Colorado, USA. hayaship@slu.edu
Mao
Jae
J
Slater
Kellee
K
Liao
Robert
R
Durham
Janette D
JD
Carroll
John
J
Everson
Gregory T
GT
Kam
Igal
I
Forman
Lisa M
LM
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