Atriocaval shunt

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Atriocaval shunt is a medical procedure used in the management of certain types of cardiac tamponade and traumatic cardiac injury. This procedure involves the creation of a shunt (a bypass route) between the atrium of the heart and the inferior vena cava, which is one of the large veins that return deoxygenated blood to the heart. The atriocaval shunt is typically considered in situations where there is significant obstruction to the flow of blood into the heart, such as in the case of a penetrating cardiac injury or when there is a need to relieve pressure from cardiac tamponade, a condition where fluid accumulation in the pericardium (the sac around the heart) prevents the heart from filling properly.

Indications[edit | edit source]

The primary indication for an atriocaval shunt is to manage life-threatening conditions that obstruct venous return to the heart, including:

  • Severe Cardiac Tamponade where pericardiocentesis (removal of fluid from the pericardium) is not possible or effective.
  • Traumatic injuries to the heart or great vessels where direct repair is not immediately feasible.

Procedure[edit | edit source]

The atriocaval shunt procedure involves the surgical insertion of a tube or shunt between the inferior vena cava and the right atrium. This allows blood to bypass the area of obstruction or injury, ensuring that blood can continue to flow to the heart and then to the rest of the body. The procedure is highly invasive and is typically performed in an emergency setting by a cardiothoracic surgeon.

Risks and Complications[edit | edit source]

As with any surgical procedure, the atriocaval shunt carries risks, including:

  • Infection
  • Bleeding
  • Potential for arrhythmias due to manipulation of the heart
  • Risk of shunt dislodgement or blockage

Outcomes[edit | edit source]

The success of an atriocaval shunt depends on various factors, including the patient's overall health, the severity of the injury or condition being treated, and the timeliness of the intervention. In some cases, this procedure can be lifesaving, providing a critical bridge until more definitive surgical repairs can be made.

See also[edit | edit source]


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Contributors: Prab R. Tumpati, MD