Abstract
Insertion of a transjugular intrahepatic portosystemic shunt (TIPS) has proven effective in alleviating complications to portal hypertension such as refractory ascites and variceal bleeding in patients with cirrhosis. Moreover, it increases survival in selected patient groups. However, TIPS also causes marked circulatory changes and a central concern has been whether this could negatively affect cardiac function. Therefore, this review aims to critically discuss our knowledge on cardiovascular effects of a TIPS in cirrhosis. These suggest that TIPS does not worsen cardiac function. Careful cardiac evaluation prior to TIPS is, however, a prerequisite in order to prevent cardiac complications after TIPS insertion. The focus on cirrhotic cardiomyopathy has raised the awareness on specific procedures such as TIPS. Thus, previous studies have demonstrated that TIPS seemingly worsens cardiac function with a negative effect on ascites clearance and survival. However, recent studies have not been able to establish this deleterious interplay and the overall frequency of cardiac failure after TIPS still remains low. Hence, TIPS seems to be safe with regard to cardiac function in patients with cirrhosis.
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