Iliac-Mesenteric-Atrial Shunt Procedure for Budd-Chiari Syndrome Complicated by Inferior Vena Caval Thrombosis

Abstract
A 33 yr old woman had a diagnosis of idiopathic Budd-Chiari syndrome complicated by inferior vena caval occlusion. Conservative medical therapy failed to control the symptoms of both portal hypertension and vena caval stasis. A prosthetic shunt was placed from the right common iliac vein to the right atrium with a side-arm to the superior mesenteric vein. She exhibited almost complete relief of symptoms and the graft was documented to be patent 2 wk postoperatively. In many instances aggressive surgical therapy may help these patients who previously were relegated to symptomatic therapy.