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Acute PVT and TIPS

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Posted 9/12/2012 4:12 PM (GMT -8)
My wife had bariatric surgery (sleeve gastrectomy) 2 weeks ago and last week we went to the ER for severe abdominal pain. A CAT scan was performed and a newly-formed PVT was discovered. She was admitted and has been on blood thinners (heparin and now coumadin) and the Intervention Radiologist is now leaning toward a TIPS procedure. Her liver is healthy and she has no disease in that regard, it's just an acute PVT condition.

The more I read about TIPS the more confused I get. The mortality rates seem really high in some studies - like 46% two years out. Can that be right? Is that from the procedure or is it so high because most of those people had underlying conditions they died from?

I can't find any information about people living with TIPS after an acute condition and how they are doing. I am getting scared for my wife. Can anyone weigh in on this?
Posted 9/12/2012 4:40 PM (GMT -8)
Idolwild, welcome. I'm a bit confused, though. PVT=Paroxysmal Ventral Tachycardia, a heart condition. I've only heard of a TIPS being done for intractible ascites. The main risk with TIPS in a liver patient is that HE (hepatic encephalopathy) can get worse. I don't think it has a high mortality rate in these patients.

I feel you may be in the wrong forum. Perhaps you should check out a cardiac forum.

Hugs,
Connie
Posted 9/12/2012 4:42 PM (GMT -8)
PVT = Portal Vein Thrombosis, a blockage in the vein bringing blood from the bowels to the liver for cleaning. It's a simple blood clot in a very bad place.
Posted 9/12/2012 4:53 PM (GMT -8)
Connie,

I think idol wind was referring to portal vein thrombosis.

Idolwind,

I had the tips Feb 2011 for an old portal vein clot which compromised my portal vein. They were successful in removing the clot.

I have had no problems with my tips except for stenosis which has required 2 revisions. I do have cirrhosis due to idiopathic hepatitis and waiting for a transplant. My tips was explained to me as a bridge to transplant.

Do ask the interventional radiologist how many tips he has done and the mortality rate.Since I need a transplant, the decision to do the tips was a no brainier.
Posted 9/12/2012 6:05 PM (GMT -8)
Idol and Susie, thanks very much for clarifying that for me.

Hugs,
Connie
Posted 9/12/2012 6:34 PM (GMT -8)
Idolwild , TIPS in most cases such as mine is a temporary fix to a long term problem , It can have adverse effects like Hepatic Encephalopathy increase , It could simply not flow properly and clog . As with any surgery performed under anesthetics you may not wake up . The shunt insertion device that is inserted into the neck and maneuvered down a vein to the liver could possibly damage another organ or vein during it's travel .

The statistics aren't great and they get worse the further out from the operation , My Hepatologist was very upfront about all this info prior to surgery . I am roughly 4 years out since the surgery , That tends to be the average for problems to arise . I am happy to report that all seems fine so far and it's being monitored closely every 3 months now since I've hit the 4 year point . I just got back from a day at the docs office Monday and should know results tomorrow .

The point of doing the surgery is to hopefully provide you with quality of life until it's time for a transplant , I was in pretty bad pain and at my ropes end when the option came available . " It's about quality of life not quantity " as my doctor put it , I should mention that there are a number of cases that patients have exceeded 10 years or died from causes not related to TIPS .


A. Ziffle
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