A man in his 40s presented with haematemesis and melaena and was found to have a massive variceal bleed. Endoscopic procedures were ineffective at controlling the bleed; thus, an emergent transjugular intrahepatic portosystemic shunt (TIPS) procedure was performed. There were no noted complications from the procedure and the patient was eventually discharged home. A month later, a murmur was auscultated on routine physical examination. This prompted an outpatient transthoracic echocardiogram which revealed a TIPS stent in the inferior vena cava (IVC) extending into the right atrium along with a ruptured sinus of Valsalva with left to right shunt.The patient declined surgical intervention. He is currently being followed in the outpatient setting with serial echocardiograms and medical management.
Keywords: Cardiovascular medicine; GI-stents; Interventional radiology; Ultrasonography; Varices.
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