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Updated: Aug 18, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Esophageal varices without portosystemic venous pressure gradient in a patient with post-pericardiotomy constrictive
Kazuyuki Ozaki1, Makoto Kodama, Fumio Yamashita
1Division of Cardiology, Niigata University Graduate School of Medical & Dental Sciences, Asahimachi-dori 1-757, Niigata, Niigata 951-8510. k-ozaki@med.niigata-u.ac.jp
Abstract:
A 51-year-old woman was admitted with intractable congestive heart failure and progressive anemia. She had undergone mitral valve replacement for mitral regurgitation at age 23 years. Subsequently, her mitral prosthesis was replaced twice due to thrombotic stack and valve insufficiency. Signs of congestive heart failure became evident at age 46 years. Gastrointestinal endoscopy revealed esophageal varices, which were treated by endoscopic variceal ligation. Cardiac catheterization disclosed elevated pulmonary capillary wedge pressure (mean 16 mmHg), right atrial pressure (mean 15 mmHg), and hepatic vein wedge pressure (mean 15 mmHg). She died at age 53 years. Autopsy showed severe congestive liver but not liver cirrhosis. Esophageal varices may progress in spite of the absence of porto-systemic pressure gradient in patients with severely high venous pressure.
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