Peritoneal Atrial Shunt for Intractable Ascites

Abstract
MECHANICAL means have in the past been tested to drain peritoneal fluid into the venous system1,2 but none has been successful due mainly to a propensity for clotting. The analogous problem of draining cerebrospinal fluid in hydrocephalus has been assisted by insertion of a manually compressable subcutaneous pump in the line which helps to keep the system patent.3,4 Smith reported using such a device for drainage of ascitic fluid in one patient.5 This is a report of the development of a peritoneal-right atrial shunt fitted with a plastic clearing pump that has been used in eight patients. Description of Device The shunt has three elements: the intraperitoneal collecting sump, the connecting tubes containing the one-way valves, and the flushing pump. Each has undergone progressive modification during this clinical experience.6,7 The shunt now used is illustrated (Fig 1). Sump. —The intraperitoneal collecting device consists of a double