LeVeen shunt

LeVeen shunt

Etymology: Harry H. LeVeen, American surgeon, b. 1914

a tube that is surgically implanted to connect the peritoneal cavity and the superior vena cava to drain accumulated fluid from the peritoneal cavity. It is used in cirrhosis of the liver, right-sided heart failure, or abdominal cancer. Before surgery a sodium-restricted diet and diuretics are used to decrease sodium and water retention. With the patient under general anesthesia, a silicone rubber tube is inserted under the subcutaneous tissue from the peritoneal cavity to the superior vena cava. As the patient inhales, the fluid pressure in the peritoneal cavity increases, and that in the blood vessel falls, allowing peritoneal fluid to enter the shunt valve. After surgery the patient is closely observed for signs of occlusion of the shunt, GI bleeding, or leakage of peritoneal fluid from the incision. Excessive dilution of the blood may lead to coagulation abnormalities.

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LeVeen shunt

a peritoneal-venous shunt used in the control of ascites. It routes excess ascitic fluid out of the peritoneal cavity and into the superior vena cava or the jugular vein.

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LeVeen shunt

Long-term care A hydraulic device with a specialized valve that opens with a low pressure gradient–3 cm H₂O, used to drain ascitic fluid from the peritoneal cavity Pros Improves systemic hemodynamics, liver function, nutrition, survival, ↓ renin and aldosterone Cons Coagulopathy, infections, CHF, pulmonary edema, variceal bleeding, vena cava obstruction with superior vena cava syndrome Indications Management of ascites with/without cirrhosis, hepatorenal syndrome Contraindications Rapidly progressive liver failure, encephalopathy, organic–ie, not mechanical renal failure, heart failure, present/past variceal bleeding, coagulopathy, severe infections, especially peritonitis