Hemodynamic Observations Following Arterialization of the Portal Vein

Tutassaura, H

doi:10.1001/archsurg.1972.04180050070016

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…[15] or following partial reduction of the portal flow in dogs by Shaffey and H assab [14]. In this animal, complete diversion of the portal blood also produces a slight increase in the hepatic arterial flow, although never to the extent of preoperative HBF [16], The present results would suggest that although hepatic arterial flow represents a similar fraction of total liver blood flow in rats [12] and in dogs [8,13], it is more readily to in crease in rats than in dogs following PCS.…”

Section: Commentsmentioning

confidence: 97%

“…The values of EHBF obtained in normal rats were comparable to those usually reported in this species [7, 11J. In contrast with the results usually obtained in other species, HBF was not decreased 24 h following an end-to-side PCS in the rat. In dogs, Tutassaura and Baird [16] showed that PCS produced an immediate de crease of HBF to approximately 50% of its preoperative value. It has been shown by H allett el al.…”

Section: Commentsmentioning

confidence: 98%

“…Experimental studies performed in normal dogs [9,16] have shown a persistent decrease of hepatic blood flow fol lowing portal-systemic shunt. On the other hand, the outcome of hepatic blood flow in shunted cirrhotic patients is variable [2,17], In the rat, physiological and metabolic consequences of portacaval shunt have been widely investigated [1,5,10], but no correlation has been established with liver hemodynamics.…”

Section: Introductionmentioning

confidence: 99%

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Does Hepatic Blood Flow Decrease after Portal-Systemic Shunt?

Chauvaud¹,

Grange²,

Franco³

et al. 1973

Eur Surg Res

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The precise effect of portacaval shunt upon liver blood flow is still under discussion. In the present work, the consequences of portal-systemic shunt on hepatic blood flow were investigated in rats with normal liver. Hepatic blood flow was measured 24 h after a portacaval shunt according to the technique of constant Bromsulphalein infusion. There was no decrease of hepatic blood flow. Thus, at that time in the rat the increase in the hepatic arterial flow was able to totally compensate portal blood diversion, as opposed to what has been reported in the dog. It is suggested that extrapolation to man of previous work showing changes in blood flow in the dog should be reconsidered.

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Section: Commentsmentioning

confidence: 97%

Section: Commentsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does Hepatic Blood Flow Decrease after Portal-Systemic Shunt?

Chauvaud¹,

Grange²,

Franco³

et al. 1973

Eur Surg Res

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“…This has been attributed to deprivation of the liver from blood coming from the splanchnic area. The signs of portal encephalopathy can be prevented when the venous hepatic blood flow is preserved by means of a portacaval transposition (3-5) or by anastomosing an artery to the stump of the transected portal vein after construction of an Eck's fistula (6)(7)(8)(9). The rationale for hepatic arterialization of the portal vein stump at the time that an end-to-side portacaval shunt is constructed is based on the assumption that the arterial blood will adequately perfuse the liver, although its contents are somewhat different from those of blood coming from the splanchnic area.…”

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confidence: 99%

Long term effects of arterialization of the portal vein stump in dogs with Eck's fistula

1981

Journal of British Surgery

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This study investigates the possibility of avoiding the sequelae of Eck's fistula in dogs by preserving the hepatic blood flow with an autologous vein graft inserted between the infrarenal aorta and the transected stump of the portal vein as its entrance into the liver. Ten dogs with such experimental preparation were observed for signs of encephalopathy; the patency of the grafts was assessed by periodic arteriograms. The signs of encephalopathy and general deterioration usually observed in dogs with Eck's fistula were prevented; however, marked dilation of the intrahepatic branches of the portal vein leading sometimes to spontaneous rupture of the liver or to thrombosis of the venous graft was observed. Thus, this technique does not appear to be a satisfactory long term solution for preventing the deleterious effects of Eck's fistula in dogs.

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“…Im Gegensatz zuRestrepo u. Warren (1962), die nach portocavalem Shunt eine kontinuierliche Abnahme der Leberdurchblutung fanden, und zuTutassaura et al (1972), die einen Anstieg des Blutflusses der A. hepatica bei Hunden mit Shunt und Arterialisation beschrieben, fund sich in unseren Experimenten ein im wesentlichen gleichbleibender Blutflu• der A. hepatica sowohl nach portocavalem Shunt allein als auch nach Shunt und Arterialisation.Bei den arterialisierten Tieren ersetzt die Blutzufuhr durch das Interponat nach l0 Wochen quantitativ das abgeleitete Blut der Pfortader, so dab sich der GesamtleberblutfluB dieser Gruppe nicht von den Ausgangswerten unterscheidet (Tabelle t).Abb. Leberblutflui} (MW _+ SD)bciden anderen Tiere fiberlcbten diese Phase, jedoch fund sich bei der abschlieBenden Laparatomie nach i0 Wochen bei einem Tier ein thrombosiertes Veneninterponat, bei dem anderen Tier zwar ein durchg~ingiges Interponat jedoch nut ein minimaler BlutfluB.…”

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Die kontrollierte arterialisation der leber

Funovics

Gangl

Horak

et al. 1974

Langenbecks Arch Chiv

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The effects of portacaval shunt with and without arterialization of the hepatic portal vein were studied in dogs. An end-to-side portacaval shunt was performed in all animals, and in one group this was followed by the interposition of an external jugular vein graft between the hepatic stump of the portal vein and the abdominal aorta. The dogs were observed over a period of 10 weeks.Portocaval shunt alone caused a decrease in liver blood flow from 38.5 ± 13.3 to 10.5 + t.7 ml/kg/min (P < 0.001), hepatic atrophy, impaired indocyanin green clearance from 101 _+ 022 to 053 _+ 014 (P < 0.001) and increased concentrations of ammonia from 48 + 13 to 155 ± 36 (P < 0.001) and bile acids from 3 ± 2 to 239 _+ 93 (P < 0.001) in the peripheral blood.These effects were prevented by arterilization of the liver. Thrombosis of the arterial graft and increase in intrahepatic blood pressure were the two major complications of arterialization which were observed.These findings indicate that depriving the liver of portal blood causes pathophysiological changes which may be responsible for the well known complications of liver failure and encephalopathy observed following portocaval anastomosis in cirrhotic patients. The fact that arterialization of the portal vein minimizes these changes encourages the application of this procedure in the treatment of portal hypertension in man. Key words: Portacaval Shunt --Arterialization of the Liver.Zusammen/assung. Die pathophysiologischen Ver~nderungen des portocavalen Shunt und der Einflul] der Arterialisation der Leber auf diese Mechanismen wurden an Hunden untersucht. Ein portocavaler End-zu-Seit-Shunt wurde bei allen Tieren durchgeffihrt. In einer Gruppe wurde durch Interposition der V. jugularis externa zwischen dem Stumpf der Pfortader und der Aorta abdominalis eine druck-und durchfluBkontrollierte Arterialisation der Leber angeschlossen. Die Tiere wurden l0 Wochen beobachtet.Der portocavale Shunt fiihrte zu einer Reduktion des Leberblutflusses yon 38,5 + 13,3 auf 10,5 _+ 1,7 ml/kg/min (P < 0,001) zur Atrophic der Leber, zur Ein-22*

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Hemodynamic Observations Following Arterialization of the Portal Vein

Cited by 5 publications

References 10 publications

Does Hepatic Blood Flow Decrease after Portal-Systemic Shunt?

Does Hepatic Blood Flow Decrease after Portal-Systemic Shunt?

Long term effects of arterialization of the portal vein stump in dogs with Eck's fistula

Die kontrollierte arterialisation der leber

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