Nonconventional mesocaval prosthetic shunt interposition in refractory case with portal hypertension in a 10-kg female infant

Surgical treatment of portal hypertension in infants is challenging because of the high risk of shunt thrombosis. A 10-kg female infant underwent six failed procedures before being successfully treated by interposition of a 10-mm-diameter prosthetic graft between two 3-mm-diameter splanchnic veins and the inferior vena cava. Follow-up at 10 years demonstrates shunt patency and normal development without rebleeding. An aggressive surgical strategy is justified as long as even nonconventional techniques are available to prevent life-threatening complications of portal hypertension. Prosthetic grafts can be used when no autologous vein graft is available. Decellularized allografts with reduced immunogenicity may also be effective alternative materials. Keywords: mesocaval anastomosis, PHT, prosthetic shunt