Peritoneovenous Shunt

Excerpt

A peritoneovenous shunt (PVS) is a connection between the peritoneal cavity and the systemic venous circulation via a shunting tube placed subcutaneously connected with a one-way pressure valve. It allows continuous drainage of the peritoneal fluid from the peritoneum into the venous system, mainly the internal jugular vein (IJ) or the superior vena cava(SVC). It was first introduced by Harry H Leveen et al. in 1974, and since then, various modified designs have seen use in clinical practice for the management of chronic refractive ascites.

Ascites is the pathological accumulation of excess fluid within the peritoneal cavity - this may be due to excessive production or inadequate drainage of peritoneal fluid. The pressure difference between the two ends of the shunt allows the drainage of ascitic fluid from the high-pressure peritoneal cavity towards the low-pressure central venous system. Flow is maintained when the pressure difference between the two ends reaches 30 to 50 mm of water. Below 30 mm of water, the one-way shunt closes, preventing the backflow of blood into the venous end of the tubing.