C.: Comparison of wedged hepatic vein pressure with portal pressure in human subjects with cirrhosis

A method of assessing portal venous pressure in animals by wedging a cardiac catheter into a peripheral hepatic venule was described by Myers and Taylor (1) and by Friedman and Weiner (2). The application of this technique in humans has been reported by Myers and Taylor (1), Paton, Reynolds, and Sherlock (3), and Krook (4). It seems clear from the evidence presented that the presence of portal hypertension- can be reliably predicted from the finding of an elevated wedged hepatic vein pressure (WHVP). Paton, Rey-nolds, and Sherlock have shown that in patients without liver disease WHVP measures only a few mm. Hg more than right atrial pressure (3). Likewise in non-cirrhotic liver disorders not as-sociated with portal hypertension WHVP is nor-mal (3). By contrast in a large number of cir-rhotic subjects reported by the aforementioned three groups of investigators WHVP was in-variably elevated to some degree. This technique would be more valuable if it were known how closely the pressure measured in the wedged position corresponded to actual portal venous pressure (PVP). In cats (1) and in dogs (2) WHVP was found to be almost iden-tical with PVP both in the normal animal and when both pressures had been elevated by epineph-rine injection. In two human subjects with por-tal hypertension, PVP, measured postoperatively through a polyethylene tube leading from an omental vein, compared favorably with WHVP measured preoperatively (3). To our knowl