AIIMS Bhopal’s Cardiology Department Performs Central India’s First Transcatheter Closure of a Rare Intrahepatic Portocaval Shunt in a Child

AIIMS Bhopal’s Cardiology Department Performs Central India’s First

Transcatheter Closure of a Rare Intrahepatic Portocaval Shunt in a Child

Bhopal. Under the guidance of Prof. (Dr.) Ajai Singh, Executive Director of AIIMS Bhopal, the institution has once again demonstrated its excellence in medical research, innovation and patient care. Recently, the cardiology department at AIIMS Bhopal successfully performed the transcatheter closure of a rare portocaval shunt, a condition involving abnormal vascular connections between the portal vein and the hepatic vein. This marks the central India first such Intervention. A 9-year-old boy presented at AIIMS Bhopal with right foot trauma requiring debridement. During pre-operative evaluation, his oxygen saturation (SaO2) was notably low at 75%, and he exhibited cyanosis. He was referred to the cardiology department for further assessment. Dr. Bhushan Shah of cardiology department performed a bubble contrast echocardiography study which suggested an extracardiac pulmonary arteriovenous malformation (AVM). Subsequent abdominal ultrasonography revealed an intrahepatic portocaval shunt (patent ductus venosus). Diagnosis was confirmed with CT pulmonary angiography and cardiac CT, establishing the presence of a Ductus Venosus shunt. The patient had a significantly elevated ammonia levels, which could lead to hepatic encephalopathy and portal hypertension, hence necessitated intervention. The cardiology team lead by Dr.Bhushan Shah planned a transcatheter closure of the Ductus Venosus shunt. The procedure was performed via neck  vein and a nitinol device was successfully deployed into the intrahepatic Ductus Venosus. Follow-up angiography confirmed no residual shunting, and the patient’s ammonia levels normalized on post-closure follow up.

Prof. Singh highlighted the significance of this achievement and said: "This transcatheter procedure represents a monumental step in the field of pediatric cardiology in India. It not only highlights the technical expertise and dedication of our medical teams but also underscores AIIMS Bhopal's commitment to advancing healthcare and providing cutting-edge solutions to complex medical conditions." The surgical team included Dr. Bhushan Shah, Dr. Sudesh Prajapati, and Dr. Ashish Jain from the Cardiology Department, along with Cardiac Anesthetist Dr. Harish.