IMO 1208 Diagnostic significance of severe portal vein pulsatility in patients with cardiac disease

Doppler sonographic diagnosis of severe portal vein pulsatility in constrictive pericarditis: Flow normalization after pericardiectomy

“…In an effort to find new explanations for the phenomenon of SPP in cardiac patients, data have recently been presented suggesting that severe pulmonary hypertension may induce SPP irrespective of the degree of TR. 13 In the case discussed, however, the systolic pulmonary artery pressure was found to be normal. We assume that the high mean RAP of 17 mm Hg in this patient led to increased hepatic venous outflow resistance with subsequent trans-sinusoidal shunting between the hepatic artery and portal vein, similar to the mechanical outflow block that causes SPP in liver cirrhosis and Budd-Chiari syndrome.…”