A caval homograft for Budd-Chiari syndrome due to inferior vena cava obstruction

被引：12

作者：

Mancuso, Andrea ^{[1
]}

Martinelli, Luigi ^{[2
]}

De Carlis, Luciano ^{[3
]}

Rampoldi, Antonio Gaetano ^{[4
]}

Magenta, Giovanni ^{[5
]}

Cannata, Aldo ^{[2
]}

Belli, Luca Saverio ^{[1
]}

机构：

[1] Osped Niguarda Ca Granda, Epatol & Gastroenterol, Piazza Osped Maggiore 3, I-20162 Milan, Italy

[2] Osped Niguarda Ca Granda, Cardiochirurg, I-20162 Milan, Italy

[3] Osped Niguarda Ca Granda, Chirurg Gen & Trapianti, I-20162 Milan, Italy

[4] Osped Niguarda Ca Granda, Radiol Interventist, I-20162 Milan, Italy

[5] Osped Niguarda Ca Granda, Cardiol 3, I-20162 Milan, Italy

来源：

WORLD JOURNAL OF HEPATOLOGY | 2013年 / 5卷 / 05期

关键词：

Budd-Chiari syndrome; Inferior vena cava; Occlusion; Surgery; Liver transplantation;

D O I：

10.4254/wjh.v5.i5.292

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Transjugular intrahepatic portosystemic shunt (TIPS) is the standard treatment of Budd-Chiari syndrome (BCS) non responsive to medical therapy. However, patients with inferior vena cava (IVC) obstruction proximal to the atrium do not benefit from TIPS and a surgical approach is mandatory. We report the case of BCS due to intrapericardial IVC obstruction. We describe a novel surgical approach using a fresh caval homograft. An attempt to balloon dilatation of the IVC obstruction was complicated by right atrial disruption with tamponade and ventricular fibrillation. Lately, the patient successfully underwent a reconstruction of the cavoatrial continuity by the interposition of a fresh caval homograft, a novel surgical approach never described before for BCS. Further follow-up revealed progressive reduction and resolution of ascites, and overall clinical improvement. IVC obstruction near to the atrium can be surgically approached with a new technique consisting in inferior vena cava resection and replacement with a caval homograft. (C) 2013 Baishideng. All rights reserved.

引用

页码：292 / 295

页数：4

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