Mesocaval and Portacaval Shunts Using Panelled Bovine Arterial H Grafts

Abstract

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.