The effect of small diameter portocaval shunt on cardiac performance in portal hypertensive patients with bleeding oesophageal varices

Abstract

This study included 15 patients with portal hypertension and bleeding . oesophageal varices that were ready for operative intervention. All patients were subjected to thorough clinical evaluation and examination, routine laboratory investigations, Duplex study of the portal area. Preoperative and postoperative cardiac evaluation was done through plain X-ray chest, ECG and echo-cardiography, and of them were subjected to small diameter portocaval shunt as described by Sarfeh, and liver biopsy was taken intraoperatively.

Postoperatively, all of them showed significant decrease in portal vein diameter and flow and non-significant decrease in splenic vein diameter and flow.

Echo-cardiographic changes showed increase in end-diastolic diameter and end diastolic volume and ejection fraction, fractional shortening, stroke volume, heart rate, cardiac output and cardiac index. It also showed non­ significant change in end systolic diameter and volume.