Abstract
Surgical correction of congenital portosystemic venous shunt (CPSVS) is sometimes associated with remarkable hemodynamic deterioration and poor outcome due to decreased venous return, portal hypertension and severe splanchnic congestion. This may occur especially in patients with severe hepatic insufficiency. We present the case of a 43-day-old female with CPSVS located between the umbilical portion of the portal vein and the right atrium. Anesthesia was induced with thiopental, fentanyl and vecuronium. In addition to the arterial and central venous pressures, portal venous pressure was monitored intraoperatively. The shunt vessel was ligated after a temporary test occlusion without remarkable hemodynamic alterations. The patient recovered without any complications.
Intraoperative monitoring of the portal venous pressure along with preoperative evaluation of the liver parenchyma and portal system was useful in the management of CPSVS.
