A Method for Controlling Portal Pressure After Attenuation of Intrahepatic Portacaval Shunts |
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| Authors: | R N WHITE BSc BVetMed CertVA MRCVS N D TROWER MA VetMB MRCVS F J McEVOY MVB DVR MRCVS O A GARDEN BSc BVetMed MRCVS A BOSWOOD MA VetMB CenSAC MRCVS |
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| Institution: | Department of Small Animal Medicine and Surgery, Royal Veterinary College, University of London, Hawkshead Lane, Hatfield, Herts, United Kingdom AL9 7TA. |
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| Abstract: | Two dogs had right divisional intrahepatic portacaval shunts within the right lateral lobe of the liver. In both dogs, an extrahepatic portacaval vascular anastomosis was created, using an autologous right external jugular vein graft. The intrahepatic shunts were completely attenuated using a prehepatic intravascular caval approach. The creation of the vascular graft allowed postattenuation rises in portal pressure to be controlled, preventing the development of life threatening portal hypertension. Both dogs recovered from the procedure. One dog is clinically normal and does not require medication (8 months postoperatively); the other dog was euthanatized 5 months after surgery because of renal failure. Scintigraphy studies, performed before surgery, showed significant shunting of portal blood away from the liver (shunt indices 65% and 59%), whereas, similar studies done 4 weeks afterwards showed almost normal portal blood flow (shunt indices 16% and 18%, respectively). |
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