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December 1974

Mesocaval and Portacaval Shunts Using Panelled Bovine Arterial H Grafts

Author Affiliations

From the Department of Surgery, Rutgers Medical School, College of Medicine and Dentistry of New Jersey and Middlesex General Hospital (Drs. Rosenberg and Konigsberg), New Brunswick, NJ.

Arch Surg. 1974;109(6):754-758. doi:10.1001/archsurg.1974.01360060024006

Mesocaval and portacaval H grafts have been utilized for portal hypertension and its complications as a technically easier operation more applicable to the poorer risk patient. In this study the modified bovine arterial graft, with handling qualities superior to those of the usually employed Dacron prosthesis, was appropriately panelled to form tubes of 18 to 20 mm in diameter and used as interposition shunts in nine poor-risk patients. Long-term follow-up demonstrated satisfactory rehabilitation in all but one patient, who continued to drink. Patency of the grafts was demonstrated either angiographically or at autopsy in eight of nine cases.

The panelled bovine arterial graft provides a useful alternative to the large-bore Dacron prosthesis as an interposition or H graft in portal venous decompression procedures.

Drapanas T:  Interposition mesocaval shunt for treatment of portal hypertension . Ann Surg 76:435-446, 1972.Article
Gliedman ML:  The mesocaval shunt for portal hypertension . Am J Gastroenterol 56:323-333, 1971.
Graziano JL, Sullivan HJ:  Portal decompression: Clinical experience with the "H" graft . Ann Surg 178:209-214, 1973.Article
Lord JW, Rossi G, Daliana M, et al:  Mesocaval shunt modified by the use of a Teflon prosthesis . Surg Gynecol Obstet 130:525-526, 1970.
Nabseth DC, O'Hara ET, Marks LJ, et al:  The "H" graft in portacaval shunts . Ann Surg 168:201-206, 1968.Article
Child CG: The Liver and Portal Hypertension . Philadelphia, WB Saunders Co, 1964, p 50.
Soyer T, Lempinen M, Cooper P, et al:  A new venous prosthesis . Surgery 72:864-871, 1972.
Stipa S, Thau A, Cavallaro A, et al:  A technique for mesentericocaval shunts . Surg Gynecol Obstet 137:285-287, 1973.
Read RC, Thompson BW, Wise WS, et al:  Mesocaval H venous homografts . Arch Surg 101:785-791, 1970.Article
Haimovici H, Hoffert PW, Zinicola N, et al:  An experimental and clinical evaluation of grafts in the venous system . Surg Gynecol Obstet 131:1173-1186, 1970.
Rosenberg N, Martinez A, Sawyer PN, et al:  Tanned collagen arterial prosthesis of bovine carotid origin in man: Preliminary studies of enzyme-treated heterografts . Ann Surg 164:247-256, 1966.Article
Rosenberg N, Lord GH, Henderson J, et al:  Collagen arterial graft of bovine origin: Seven-year observations in the dog . Surgery 67:951-956, 1970.
Rosenberg DM, Glass B, Rosenberg N, et al:  Experiences with modified bovine heterografts in arterial surgery . Surgery 68:1064-1073, 1970.
Starzl TE, Francavilla A, Halgrimson CG, et al:  The origin, hormonal nature and action of hepatotrophic substances in portal venous blood . Surg Gynecol Obstet 137:179-199, 1973.
Warren WD, Zeppa R, Fomon JJ:  Selective trans-splenic decompression of gastroesophageal varices . Ann Surg 166:437-455, 1967.Article
Salam AA, Warren WD, LePage JR, et al:  Hemodynamic contracts between selective and total portal-systemic decompression . Ann Surg 173:827-844, 1971.Article
Adamsons RJ, Kinkhabwala M, Moskowitz H, et al:  Portacaval shunt with arterialization of the hepatic portion of the portal vein . Surg Gynecol Obstet 135:529-535, 1972.
Campbell DP, Anagnostopoulos CE, Glenn WWL:  Selection of patients with portal hypertension for splenorenal shunt . Ann Surg 178:70-74, 1973.Article
Clatworthy HW Jr, Wall T, Watman RN:  A new type of portal-to-systemic venous shunt for portal hypertension . Arch Surg 71:588-599, 1955.Article
Kerstein MD, Lewis JW, Roe CF, et al:  The bovine heterograft in portacaval shunts . Conn Med 38:153-155, 1974.