Atrial laceration caused by removal of a transjugular intrahepatic portosystemic shunt necessitates emergent cardiopulmonary bypass during liver transplant: A case report

D. Tivener; A. Vannucci; R. E. Fagley; M. Doyle; S. Shenoy; W. Chapman; I. Kangrga

doi:10.1016/j.transproceed.2011.03.093

Atrial laceration caused by removal of a transjugular intrahepatic portosystemic shunt necessitates emergent cardiopulmonary bypass during liver transplant: A case report

D. Tivener, A. Vannucci, R. E. Fagley, M. Doyle, S. Shenoy, W. Chapman, I. Kangrga

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

In situ transjugular intrahepatic portosystemic shunting (TIPS) can complicate liver transplantation. We present a case where an intraoperative attempt to remove a malpositioned TIPS resulted in atrial laceration. Massive transfusion and emergent institution of cardiopulmonary bypass allowed patient resuscitation and completion of surgery. We describe our surgical and anesthesiologic management, and discuss the absence of criteria to predict when TIPS may become adherent to the inferior vena cava or the right atrium and difficult to remove.

Original language	English
Pages (from-to)	2810-2813
Number of pages	4
Journal	Transplantation Proceedings
Volume	43
Issue number	7
DOIs	https://doi.org/10.1016/j.transproceed.2011.03.093
State	Published - Sep 2011

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title = "Atrial laceration caused by removal of a transjugular intrahepatic portosystemic shunt necessitates emergent cardiopulmonary bypass during liver transplant: A case report",

abstract = "In situ transjugular intrahepatic portosystemic shunting (TIPS) can complicate liver transplantation. We present a case where an intraoperative attempt to remove a malpositioned TIPS resulted in atrial laceration. Massive transfusion and emergent institution of cardiopulmonary bypass allowed patient resuscitation and completion of surgery. We describe our surgical and anesthesiologic management, and discuss the absence of criteria to predict when TIPS may become adherent to the inferior vena cava or the right atrium and difficult to remove.",

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Tivener, D, Vannucci, A, Fagley, RE, Doyle, M, Shenoy, S, Chapman, W & Kangrga, I 2011, 'Atrial laceration caused by removal of a transjugular intrahepatic portosystemic shunt necessitates emergent cardiopulmonary bypass during liver transplant: A case report', Transplantation Proceedings, vol. 43, no. 7, pp. 2810-2813. https://doi.org/10.1016/j.transproceed.2011.03.093

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AU - Tivener, D.

AU - Vannucci, A.

AU - Fagley, R. E.

AU - Doyle, M.

AU - Shenoy, S.

AU - Chapman, W.

AU - Kangrga, I.

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AB - In situ transjugular intrahepatic portosystemic shunting (TIPS) can complicate liver transplantation. We present a case where an intraoperative attempt to remove a malpositioned TIPS resulted in atrial laceration. Massive transfusion and emergent institution of cardiopulmonary bypass allowed patient resuscitation and completion of surgery. We describe our surgical and anesthesiologic management, and discuss the absence of criteria to predict when TIPS may become adherent to the inferior vena cava or the right atrium and difficult to remove.

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Atrial laceration caused by removal of a transjugular intrahepatic portosystemic shunt necessitates emergent cardiopulmonary bypass during liver transplant: A case report

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