Vnitr Lek 2013, 59(7):587-590

Hepatic vein catheterisation - selected assessment aspects

J. Petrtýl^1,*, R. Brůha¹, P. Urbánek², Z. Mareček³, M. Kaláb¹

¹ IV. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Aleš Žák, DrSc.

² Interní klinika 1. lékařské fakulty UK a ÚVN Praha, přednosta prof. MUDr. Miroslav Zavoral, Ph.D.

³ KlinMed s.r.o., Praha, vedoucí prof. MUDr. Zdeněk Mareček, DrSc.

Introduction:
Hepatic vein catheterisation and portal hypertension assessment using the value of portal hepatic gradient (HVPG) is currently a method of choice.

Methodology:
In our paper we shall compare HVPG with the so-called direct gradient - using the difference in pressure in the portal vein and free hepatic vein in 5 groups of patients with liver cirrhosis.

Results:
Hepatic vein catheterisation is reliable for assessing the portal hypertension in the group of patients with liver cirrhosis of ethylic etiology. In patients with liver cirrhosis resulting from hepatitis B, Wilson's disease or primary biliary cirrhosis, a statistically significant difference between HVPG and the direct gradient has been found. In patients with liver cirrhosis resulting from hepatitis C the obtained values differed but without statistical significance.

Conclusion:
In catheterisation of hepatic veins the HVPG value in liver cirrhosis with a presinusoidal component may be reduced, which has to be primarily taken into account when assessing the relationship to some critical values of the portal hepatic gradient.

Keywords: portal hypertension; hepatic vein catheterisation; liver cirrhosis; portal hepatic gradient

Received: May 8, 2013; Published: July 1, 2013  Show citation