Direct measurement of porto-systemic gradient in a failing fontan circulation
Direct measurement of porto-systemic gradient in a failing fontan circulation
We describe the case history of a 42-year-old man with cardiac cirrhosis, portal hypertension, and life-threatening variceal bleeding after Fontan revision surgery. Direct pressure measurements in the portal vein, though high, demonstrated only a modest portosystemic gradient (PSG), 9 mm Hg. A transjugular intrahepatic portosystemic shunt procedure was performed. This reduced the PSG (3 mm Hg). His bleeding was controlled. The patient's histopathological findings were identical to that previously documented in Fontan patients, raising the question of whether these subdiaphragmatic hemodynamics are representative of the broader failing Fontan population.
fontan circulation, transjugular intrahepatic portosystemic shunt, cardiac cirrhosis, portal hypertension
175-178
Velpula, Madhavi
ac82948d-a90b-45b2-9df6-8a34eba2b0c2
Sheron, Nick
cbf852e3-cfaa-43b2-ab99-a954d96069f1
Guha, Neill
bae415f6-daa3-4b21-82ee-ec529ee2c28a
Salmon, Tony
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Hacking, Nigel
fdc70f9c-e9d6-485c-a53d-e6988fa75cb0
Veldtman, Gruschen R.
d9b03375-5c07-46b8-9d85-8ac5b0f8e08a
1 March 2011
Velpula, Madhavi
ac82948d-a90b-45b2-9df6-8a34eba2b0c2
Sheron, Nick
cbf852e3-cfaa-43b2-ab99-a954d96069f1
Guha, Neill
bae415f6-daa3-4b21-82ee-ec529ee2c28a
Salmon, Tony
6bfc5458-fb73-4685-a42f-aff7ae83e23f
Hacking, Nigel
fdc70f9c-e9d6-485c-a53d-e6988fa75cb0
Veldtman, Gruschen R.
d9b03375-5c07-46b8-9d85-8ac5b0f8e08a
Velpula, Madhavi, Sheron, Nick, Guha, Neill, Salmon, Tony, Hacking, Nigel and Veldtman, Gruschen R.
(2011)
Direct measurement of porto-systemic gradient in a failing fontan circulation.
Congenital Heart Disease, 6 (2), .
(doi:10.1111/j.1747-0803.2010.00451.x).
(PMID:21356034)
Abstract
We describe the case history of a 42-year-old man with cardiac cirrhosis, portal hypertension, and life-threatening variceal bleeding after Fontan revision surgery. Direct pressure measurements in the portal vein, though high, demonstrated only a modest portosystemic gradient (PSG), 9 mm Hg. A transjugular intrahepatic portosystemic shunt procedure was performed. This reduced the PSG (3 mm Hg). His bleeding was controlled. The patient's histopathological findings were identical to that previously documented in Fontan patients, raising the question of whether these subdiaphragmatic hemodynamics are representative of the broader failing Fontan population.
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Published date: 1 March 2011
Keywords:
fontan circulation, transjugular intrahepatic portosystemic shunt, cardiac cirrhosis, portal hypertension
Identifiers
Local EPrints ID: 178891
URI: http://eprints.soton.ac.uk/id/eprint/178891
ISSN: 1747-079X
PURE UUID: ccbda6ac-f10b-4704-a248-e28ff60925e3
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Date deposited: 28 Mar 2011 14:06
Last modified: 14 Mar 2024 02:47
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Contributors
Author:
Madhavi Velpula
Author:
Nick Sheron
Author:
Neill Guha
Author:
Tony Salmon
Author:
Nigel Hacking
Author:
Gruschen R. Veldtman
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