Haemodynamic changes after portal vein ligation and mesocaval interposition "H" grafting in the dog. 1981

K Höckerstedt, and J Nieminen, and T M Scheinin, and H Wahl

The haemodynamic effects of portal ligation combined with mesocaval H-grafting were evaluated experimentally as follows: acute portal hypertension was induced in 20 mongrel dogs by ligation of the portal vein, in 15 of these a mesocaval shunt was constructed using an autogenous venous segment, the rest served as controls and were left without shunting. All animals with portal occlusion only died within 80 minutes, whereas nine dogs in the H-graft groups survived. The one-month patency rate was 78 per cent. Slight portal hypertension was observed only in the early post-shunt period, one month later the pressure was normal. By this time the flow through the shunt was significantly reduced and numerous but small portosystemic collaterals were visualized radiographically. Varices formation was not observed. The Xe-133 wash-out of the liver and liver pO2 were normal in the early post-shunt period. These findings were in marked contrast to those in the control group where both variables showed rapid deterioration. The pre-shunt spleen flow proved to be of prognostic significance: poor flow was associated with bad prognosis. After one month the liver flow was decreased whereas the spleen flow was increased, perhaps indicating increased splenocollateral flow. Portal ligation combined with mesocaval H-grafting thus seemed to induce slight and temporary portal hypertension in this model. This appeared to be caused by relatively narrow lumen of the shunt. Normotension was soon established by rapid opening up of portosystemic collaterals.

UI MeSH Term Description Entries
D006975 Hypertension, Portal Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN. Cruveilhier-Baumgarten Disease,Cruveilhier-Baumgarten Syndrome,Cruveilhier Baumgarten Disease,Cruveilhier Baumgarten Syndrome,Disease, Cruveilhier-Baumgarten,Portal Hypertension,Portal Hypertensions,Syndrome, Cruveilhier-Baumgarten
D008026 Ligation Application of a ligature to tie a vessel or strangulate a part. Ligature,Ligations,Ligatures
D008102 Liver Circulation The circulation of BLOOD through the LIVER. Hepatic Circulation,Circulation, Liver,Circulation, Hepatic
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D011168 Portal System A system of vessels in which blood, after passing through one CAPILLARY BED, is conveyed through a second set of capillaries before it returns to the systemic circulation. It pertains especially to the hepatic portal system. Portal Systems,System, Portal,Systems, Portal
D011169 Portal Vein A short thick vein formed by union of the superior mesenteric vein and the splenic vein. Portal Veins,Vein, Portal,Veins, Portal
D011170 Portasystemic Shunt, Surgical Surgical venous shunt between the portal and systemic circulation to effect decompression of the portal circulation. It is performed primarily in the treatment of bleeding esophageal varices resulting from portal hypertension. Types of shunt include portacaval, splenorenal, mesocaval, splenocaval, left gastric-caval (coronary-caval), portarenal, umbilicorenal, and umbilicocaval. Portosystemic Shunt, Surgical,Portasystemic Shunt,Portosystemic Shunt,Shunt, Surgical Portasystemic,Shunt, Surgical Portosystemic,Surgical Portasystemic Shunt,Surgical Portosystemic Shunt,Portasystemic Shunts,Portasystemic Shunts, Surgical,Portosystemic Shunts,Portosystemic Shunts, Surgical,Shunt, Portasystemic,Shunt, Portosystemic,Shunts, Portasystemic,Shunts, Portosystemic,Shunts, Surgical Portasystemic,Shunts, Surgical Portosystemic,Surgical Portasystemic Shunts,Surgical Portosystemic Shunts
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002496 Central Venous Pressure The blood pressure in the central large VEINS of the body. It is distinguished from peripheral venous pressure which occurs in an extremity. Venous Pressure, Central,Central Venous Pressures,Pressure, Central Venous,Pressures, Central Venous,Venous Pressures, Central

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