Mesoatrial shunt: a prosthesis modification.

The mesoatrial shunt is the indicated treatment in the Budd-Chiari syndrome when the inferior vena cava is occluded and not usable for the standard portasystemic shunts. As the mesoatrial shunt courses from the abdomen into the right side of the chest, it passes posterior to the xiphoid and sternum and frequently is compressed at this point. A prosthesis modification is reported whereby an exterior silicone rubber cuff is bonded to the Dacron or Gortex graft at the point at which it passes posterior to the sternum. This obviates the possibility of graft compression and should increase long-term patency.