What is the normal direction for the right and left portal vein to travel in a patient with a TIPS procedure?

In a patient with a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure, the normal direction for blood flow in the right and left portal veins is hepatofugal. This means that blood flows away from the liver (the portal circulation) towards the systemic circulation.

When a TIPS is created, it connects the portal vein directly to the hepatic vein, bypassing the liver sinusoids. As a result, the pressure in the portal circulation decreases, leading to a reversal of normal flow patterns. Under normal circumstances, blood flow in the portal veins is hepatopedal, meaning it flows towards the liver. However, after a TIPS procedure, the flow becomes hepatofugal because the pressure within the portal system has changed significantly due to the shunt.

Understanding this flow direction is crucial in evaluating postsurgical patients and monitoring for complications such as shunt stenosis or occlusion, where an abnormal flow pattern might suggest issues that need to be addressed.