03:27 PM Abstract No. 271 Transjugular intrahepatic portosystemic shunt (TIPS) creation, thrombolysis and thrombectomy in the management of severe, symptomatic portomesenteric venous thrombosis after bariatric surgery: retrospective review of patient outcomes

Abstract

TIPS) placement. Pre-TIPS right heart pressure may serve as a valuable prognostic indicator since patients with an elevated baseline right atrial pressure are more prone to post-TIPS heart failure. (1,2) Materials: This is a single-center, IRB-approved, retrospective study evaluating all patients who underwent TIPS from 1997 to 2017. Demographic data was collected, as well as diagnosis and indication for TIPS, elective vs. emergent TIPS placement, pre-TIPS MELD score, pre-TIPS ECHO, and pre and post TIPS intraoperative direct right atrial pressure measurements. A mean and standard deviation of the absolute difference between measurements obtained by echocardiography and right heart catheterization was obtained. Results: 392 patients underwent TIPS placement over the 20year period. Of those, 113 had pre-TIPS ECHO and pre-TIPS direct right atrial pressure measurements. The study group was 56% male, 44% female, with a mean age of 56±9.8 years. The average calculated MELD score was 13.6±5.9. 70% of patients were treated electively and the remaining 30% underwent emergent treatment. The mean and standard deviation absolute difference between measurements obtained by ECHO and direct right atrial pressure measurements was 8.1±5.3 mm Hg. Conclusions: ECHO measurements in patients undergoing evaluation for TIPS placement should be viewed with caution. Correlation of cardiac status with direct measurements of right heart pressures during TIPS placement remains imperative to accurately evaluate patient's risk for post TIPS cardiac complications.