Treatment of obstruction of the hepatic portion of the inferior vena cava with modified bypass graft surgery
Liu, W.Y.
Zhonghua Xin Xue Guan Bing Za Zhi 11(3): 169-171
1983
ISSN/ISBN: 0253-3758 PMID: 6662025 Document Number: 197229
Artificial vessels mounted by spiral steel wires were used as inferior vena cava (IVC)-right atrium bypasses in 3 cases of Budd-Chiari syndromes, 2 male and 1 female whose ages varied from 23-31 yr old. All patients suffered from the abdominal distension, hepatomegaly, ascites, edema of low extremities and dilation of the thoracic-abdominal superficial veins. The complete obstructions of IVC at the level of the orifices of hepatic vein were shown by the IVC angiogram. Under general anesthesia, a thoracic-abdominal midline incision was made, the distal end of the graft was anastomosed to the side of IVC below the renal vein, the proximal end of the graft was maneuvered through a retroperitoneal channel on the right-posterior aspect of the liver, penetrating the right diaphragm, entering the right thoracic and pericardial cavity and was anastomosed to the side wall of right atrium. The operation and postoperative course were uneventful. In 6-24 (average 18) mo. follow-up, all of the 3 patients were asymptomatic and the artificial grafts were patent. The advantages of the modified bypass graft and the operation method are discussed.