Lateral thoracotomy and cellophane handing of a congenital portoazygous shunt in a dog

Abstract

A portoazygous venous shunt was identified in the caudodorsal aspect of the thorax in a young basset hound. During thoracotomy, the anomalous vessel was encircled with sterile cellophane tape. The vein became occluded based on postoperative radiographic examination and improved clinical function five weeks after surgery.

Outcomes of Cellophane Banding for Congenital Portosystemic Shunts in 106 Dogs and 5 Cats

“…Reported clinical signs were consistent with those previously reported. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] There were 100 extrahepatic shunts and 11 intrahepatic shunts. All 5 cats had extrahepatic shunts.…”

“…Mortality and morbidity rates compare favorably with reports where attenuation was achieved by use of silk ligatures or ameroid constrictors. [1][2][3][4][7][8][9][10][11][12][13][14] In particular, the incidence of life-threatening portal hypertension was very low, despite the fact that placement of cellophane bands produced substantial shunt occlusion. Three large breed dogs had signs compatible with portal hypertension within 10 days of surgery, however all responded well to symptomatic and supportive therapy.…”

“…13,14 Two methods of slow occlusion using extravascular techniques have been reported: the ameroid constrictor (ameroid ring) [2][3][4][7][8][9]11,12 and cellophane bands. 1,5,10 Results of ameroid constrictor application have been encouraging, although a high incidence of multiple acquired shunts has been identified in published studies and anecdotally ( RM Bright, personal communication, 2000).…”

“…1 Rewarding results in a series of 11 dogs with congenital portosystemic shunts 5 led to cellophane banding being adopted as the procedure of choice for single extrahepatic shunts in dogs in Sydney, Australia. In time, cellophane banding was also used for CPS in cats, and for attenuation of intrahepatic shunts where it was possible to dissect around the shunt, or the afferent branch of the portal vein.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12] The rationale for slow attenuation is manifold, including reduced risk of life-threatening portal hypertension, speculation that slow occlusion may reduce the risk of post-ligation neurologic dysfunction, reduced operating time, less extensive intraoperative monitoring, and the fact that animals undergoing complete shunt occlusion have a better long-term prognosis than those undergoing partial attenuation only. 13,14 Two methods of slow occlusion using extravascular techniques have been reported: the ameroid constrictor (ameroid ring) [2][3][4][7][8][9]11,12 and cellophane bands.…”