2008 Annual Meeting Abstracts

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H-graft portacaval shunts reduce portal pressures and, thereby, discourage variceal rehemorrhage and promote long-term survival. This video presents our technique of small diameter prosthetic H-graft portacaval shunt.Only a limited Kocher maneuver is necessary. The IVC and portal vein are exposed. Ringed PTFE graft, 3 cm from toe-to-toe and 1.5 cm from heel-to-heel, is utilized. Portal and caval pressures are measured before and after shunting. The cava-graft anastomosis is completed first, followed by the portal vein-graft anastomosis. Shunting should decrease the portal pressures >10 mmHg and result in a gradient of <10 mmHg between the portal vein and IVC.

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