Prior to Procedure

You may have:

• A physical exam
• Blood and urine tests
• Imaging tests

In the days leading up to your procedure:

• Talk to your doctor the medicines you take. You may be asked to stop taking some up to 1 week in advance.
• Arrange for a ride and for help at home.
• Eat a light meal the night before. Don't eat or drink anything after midnight.

Anesthesia

This may be as:

• General anesthesia —you will be asleep
• Moderate sedation —will be awake but unable to feel pain

Description of Procedure

The doctor will use imaging to see the veins. A contrast material may also be used. This helps make them easier to see.

A small cut will be made in the neck. A tube will be place into a large vein in your neck. The doctor will slowly pass it down into the hepatic vein. There the doctor can measure the pressure in the veins to make sure the shunt is needed.

A contrast material may be used to better show the veins of the liver. A special needle can pass through the tube. This makes a path from the hepatic vein to the portal vein. A metal tube called a stent is placed between the veins. It's opened with a special balloon. Some blood will move through the shunt. The doctor will check the pressure levels again. If the pressure has lowered, the tube will slowly be taken out. If no change is seen, the stent may be fixed.

A bandage will be placed over the incision site.

How Long Will It Take?

2-3 hours

How Much Will It Hurt?

Anesthesia will prevent pain during the procedure. Medicines will ease pain afterwards.

Average Hospital Stay

Usually 1 night. If you have problems you will need to stay longer.

Postprocedure Care

At the Care Center

You will be watched for any signs of serious bleeding.

During your stay, the healthcare staff will lower your chances of infection by:

• Washing their hands
• Wearing gloves or masks
• Keeping your incisions covered

There are also steps you can take to lower your chances of infection such as:

• Washing your hands often and reminding visitors and healthcare staff to do the same
• Reminding your healthcare staff to wear gloves or masks
• Not allowing others to touch your incisions

At Home

Strenuous physical activities will need to be avoided for 1-2 weeks.

Bleeding caused by liver damage should stop shortly after procedure. If you had fluid in your belly, it will do down in about a month.

Follow-up appointments will be needed to make sure the stent is working as expected. Scar tissue may also eventually grow over the stent and block it. A second surgery may be needed then.