Mesoatrial shunt hemodynamics

C. Beattie, J. V. Sitzmann, John L Cameron

Research output: Contribution to journalArticle

Abstract

Hemodynamic profiles were obtained for patients with portal hypertension secondary to the Budd-Chiari syndrome who underwent mesoatrial shunting procedures. In contrast to the well-known hyperdynamic, low-resistance state of chronic cirrhosis, patients with the Budd-Chiari syndrome had normal cardiac index and systemic vascular resistance values before anesthesia and surgery. Opening the mesoatrial shunt produced a 46% (p <0.01) increase in cardiac index and a 38% (p <0.01) decrease in overall systemic vascular resistance. Right atrial pressure and pulmonary capillary wedge pressures were sharply increased - by 5.3 mm Hg and 4.7 mm Hg, respectively (p <0.01). A mathematical model was developed to assess the cause of the observed changes in systemic vascular resistance. The model suggests that the hemodynamic changes seen with shunt opening are unlikely to be the result of shunt effects alone and that dilatation of peripheral vascular beds is probable. Thus shunting converts the normal systemic vascular resistance and cardiac index of patients with the Budd-Chiari syndrome to the high-output, low-resistance state seen in patients with chronic cirrhosis. Although the physiology is complex, we conclude that the data are consistent with release, by the shunting process, of a systemic vasodilator.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalSurgery
Volume104
Issue number1
StatePublished - 1988

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Budd-Chiari Syndrome
Vascular Resistance
Hemodynamics
Fibrosis
Pulmonary Wedge Pressure
Atrial Pressure
Portal Hypertension
Vasodilator Agents
Blood Vessels
Dilatation
Theoretical Models
Anesthesia

ASJC Scopus subject areas

  • Surgery

Cite this

Beattie, C., Sitzmann, J. V., & Cameron, J. L. (1988). Mesoatrial shunt hemodynamics. Surgery, 104(1), 1-9.

Mesoatrial shunt hemodynamics. / Beattie, C.; Sitzmann, J. V.; Cameron, John L.

In: Surgery, Vol. 104, No. 1, 1988, p. 1-9.

Research output: Contribution to journalArticle

Beattie, C, Sitzmann, JV & Cameron, JL 1988, 'Mesoatrial shunt hemodynamics', Surgery, vol. 104, no. 1, pp. 1-9.
Beattie C, Sitzmann JV, Cameron JL. Mesoatrial shunt hemodynamics. Surgery. 1988;104(1):1-9.
Beattie, C. ; Sitzmann, J. V. ; Cameron, John L. / Mesoatrial shunt hemodynamics. In: Surgery. 1988 ; Vol. 104, No. 1. pp. 1-9.
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