Robert N. White
New perspectives on the development of extrahepatic portosystemic shunts
White, Robert N.; Shales, Chris; Parry, Andrew
Objective: To develop a hypothesis for the developmental modality of extrahepatic portosystemic shunts.
Methods: A retrospective review of a series of dogs and cats managed for congenital portosystemic shunts. Using these data a hypothesis for the role of preferential venous blood flow in the development of common extrahepatic PSSs was postulated. In addition, an online literature search was used to retrieve peer-reviewed data describing the detailed anatomy of shunts in dogs and cats. A systematic review of these data was used as a preliminary test of the hypothesis.
Results: In total 50 dogs and 10 cats met the inclusion criteria revealing five common and distinct shunt types. In the dog, these were spleno-caval, left gastro-phrenic, left gastro-azygos and those involving the right gastric vein. The online search confirmed that these were responsible for 94% of extrahepatic shunts described in this species. In the cat, the four shunt types observed were spleno-caval, left gastro-phrenic, left gastro-caval and left gastro-azygos. Excluding the left gastro-azygos, which from the online search was not described in the cat, the spleno-caval, left gastro-phrenic and left gastro-caval were responsible for 92% of extrahepatic shunts in this species. These data were used to develop, propose and provisionally test a hypothesis for the development of extrahepatic portosystemic shunts.
Clinical Significance: We hypothesise that it is the presence of preferential blood flow that influences the subsequent formation of one of a number of defined and consistent congenital extrahepatic portosystemic shunts in dogs and cats.
|Journal Article Type||Article|
|Journal||Journal of Small Animal Practice|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||White, R. N., Shales, C., & Parry, A. (in press). New perspectives on the development of extrahepatic portosystemic shunts. Journal of Small Animal Practice, 58(12), doi:10.1111/jsap.12728|
|Keywords||Soft tissue, Cardiovascular, Portosystemic shunt|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf|
|Additional Information||This is the peer reviewed version of the following article: White, R. N., Shales, C. and Parry, A. T. (2017), New perspectives on the development of extrahepatic portosystemic shunts. J Small Anim Pract. doi:10.1111/jsap.12728, which has been published in final form at http://onlinelibrary.wi...422578C4F55B17E.f03t03. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.|
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf
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