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

作　　者：Andrea Mancuso Luigi Martinelli Luciano De Carlis Antonio Gaetano Rampoldi Giovanni Magenta Aldo Cannata Luca Saverio Belli 

机构地区：Epatologia e Gastroenterologia,Ospedale Niguarda Cà Granda,Piazza Ospedale Maggiore 3,20162 Milano,Italy Cardiochirurgia,Ospedale Niguarda Cà Granda,Piazza Ospedale Maggiore 3,20162 Milano,Italy Chirurgia Generale e dei Trapianti,Ospedale Niguarda Cà Granda,Piazza Ospedale Maggiore 3,20162 Milano,Italy Radiologia Interventistica,Ospedale Niguarda Cà Granda,Piazza Ospedale Maggiore 3,20162 Milano,Italy Cardiologia 3,Ospedale Niguarda Cà Granda,Piazza Ospedale Maggiore 3,20162 Milano,Italy

出　　处：《World Journal of Hepatology》2013年第5期292-295,共4页世界肝病学杂志（英文版）（电子版）

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 cavo-atrial 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.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 cavo-atrial 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.

关 键 词：BUDD-CHIARI syndrome INFERIOR vena cava OCCLUSION Surgery Liver TRANSPLANTATION 

分 类 号：R543.6[医药卫生—心血管疾病]