The treatment of resistant malignant ascites by insertion of a peritoneo-atrial Holter valve

Abstract

Holter valves have been used in 9 cases to drain ascites, and in 1 case of pleural effusion, into the superior vena cava. All these effusions were due to malignant disease. Three patients died before the results of the operation could be assessed and in 1 case ascites rapidly recurred. Five patients were relieved until death from their primary disease. One patient died 3 1/4 years after insertion of the valve, but ascites had returned--probably as a result of recurrent blockage of the valve by particulate matter.

Peritoneovenous shunting for nongynecologic malignant ascites

“…[5][6][7]12 There were 11 LeVeen and 39 Denver shunts placed, and, in 3 patients, the type of shunt placed was unknown. Discarding peritoneal fluid was not practiced routinely, and the venous arm of the shunt was placed by means of a direct cutdown into the internal jugular vein when possible.…”

Pleurovenous shunt for treating refractory benign pleural effusion

“…Pollock was the first to describe the use of a PVS in 1975. The author implanted a peritoneo-atrial Holter valve to drain malignant pleural effusion into the superior vena cava [8]. The alternative Denver shunt was introduced in 1979.…”

Pleurovenous shunt in treating refractory nonmalignant hepatic hydrothorax: A case report

“…8 Some authorities applied it alternatively as a PVS to drain pleural fluid effectively. 9,10 By following the algorithm on the management of hepatic hydrothorax, liver transplantation will be considered whenever the patients are not responding to TIPS. 1,4 However, some patients may not undergo this procedure due to co-morbidities of high risk for interventions.…”