03/24/2026
NEW IN JVIR: Systematic Literature Review and Meta-analysis of the Cardiovascular Effects of Transjugular Intrahepatic Portosystemic Shunt Creation for Decompensated Liver Cirrhosis
🔍 Clinical question:
To characterize the cardiovascular (CV) effects of transjugular intrahepatic portosystemic shunt (TIPS) creation through systematic literature review and meta-analysis.
đź’ˇ Key insight:
A systematic literature review and meta-analysis of the cardiovascular effects of transjugular intrahepatic portosystemic shunt creation from 1990 to 2025 yielded 32 articles with 4,452 patients. Right atrial pressure (RAP), cardiac output (CO), cardiac index (CI), pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), and E/A ratio significantly increased immediately after transjugular intrahepatic portosystemic shunt creation. RAP and E/A ratio returned to baseline 1–6 months after TIPS creation, whereas CO, CI, PAP, and PCWP did not. The pooled incidence of symptomatic heart failure was 9% and 1-year cardiac mortality rate was 3%.
👉 Why it matters:
This comprehensive meta-analysis quantifies the specific cardiovascular changes after TIPS, confirming a non-trivial risk of heart failure and identifying diastolic dysfunction as a key predictor of post-procedural mortality to guide patient selection and management.
➡️ Full article: https://brnw.ch/21x10Vt