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What is a Portacaval Shunt?

A portacaval shunt is a surgical connection between the portal and systemic venous systems, often created to reduce high blood pressure in the liver's portal vein. This procedure can be life-saving for patients with conditions like cirrhosis, where blood flow through the liver is impeded. Curious about how this intricate surgery can improve lives? Dive deeper into the transformative power of portacaval shunts.
Donn Saylor
Donn Saylor

A portacaval shunt is a form of high blood pressure treatment that involves linking the liver's blood supply with the vein that draws blood from the lower part of the body. The surgery is considered major, and is conducted to redirect blood flow around the liver. Also known as a portal caval shunt, the operation is performed on patients with portal hypertension — present when blood pressure is high in the liver — that is most commonly caused by cirrhosis or hepatitis B or C.

During a portacaval shunt procedure, a large incision is made in the abdomen. The portal vein, from which the liver receives 75% of its blood supply, is attached to the major vein that drains blood from the lower portion of the body, the inferior vena cava. This encourages the blood to flow around the liver instead of through it, greatly reducing blood pressure in the region and safeguarding against broken veins and internal bleeding in the liver.

A portacaval shunt is used to relieve high blood pressure.
A portacaval shunt is used to relieve high blood pressure.

It is essential for healthy body function that blood flow smoothly through the liver. In individuals with cirrhosis and hepatitis B and C, the liver is severely damaged and proper blood flow is inhibited. A portacaval shunt procedure helps blood move more efficiently through the area and back up to the heart.

Portacaval shunt operations have commonly been replaced by other medical treatments, namely transjugular intrahepatic portosystemic shunting, or TIPS. TIPS is not an operation. A radiologist utilizes an x-ray machine to guide a medical shunt into the veins of the liver, which achieves the same end as a portacaval shunt: diversion of blood flow around the affected organ. It is generally performed under local anesthesia. Patients who undergo portacaval shunting have typically already tried the TIPS procedure with unsuccessful results.

Portacavl shunts are often performed on patients with portal hypertension due to liver damage.
Portacavl shunts are often performed on patients with portal hypertension due to liver damage.

The best candidates for a portacaval shunt are those who have first had a TIPS procedure which yielded an undesirable outcome. Ideal candidates usually have a chronic, progressive liver disease that requires surgery in order to extend life expectancy. Any type of serious liver damage, however, poses the risk of complications after surgery.

There are a variety of tests that can be conducted to see if an individual stands to benefit from a portacaval shunt. Blood tests and liver biopsies can find out the approximate extent of damage to the liver. Tests that determine liver functions might also be able to illustrate the need for a portacaval shunt.

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    • A portacaval shunt is used to relieve high blood pressure.
      By: niyazz
      A portacaval shunt is used to relieve high blood pressure.
    • Portacavl shunts are often performed on patients with portal hypertension due to liver damage.
      By: peterjunaidy
      Portacavl shunts are often performed on patients with portal hypertension due to liver damage.
    • Blood tests may help determine the extent of damage to a person's liver.
      By: Von Schonertagen
      Blood tests may help determine the extent of damage to a person's liver.
    • The portal vein is attached to the inferior vena cava, which drains blood from the lower portion of the body.
      By: 7activestudio
      The portal vein is attached to the inferior vena cava, which drains blood from the lower portion of the body.
    • Any type of live damage poses the risk of complications after surgery.
      By: vadim kozlovsky
      Any type of live damage poses the risk of complications after surgery.