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World J Hepatol. May 27, 2013; 5(5): 292-295
Published online May 27, 2013. doi: 10.4254/wjh.v5.i5.292
Published online May 27, 2013. doi: 10.4254/wjh.v5.i5.292
A caval homograft for Budd-Chiari syndrome due to inferior vena cava obstruction
Andrea Mancuso, Luca Saverio Belli, Epatologia e Gastroenterologia, Ospedale Niguarda Cà Granda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy
Luigi Martinelli, Aldo Cannata, Cardiochirurgia, Ospedale Niguarda Cà Granda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy
Luciano De Carlis, Chirurgia Generale e dei Trapianti, Ospedale Niguarda Cà Granda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy
Antonio Gaetano Rampoldi, Radiologia Interventistica, Ospedale Niguarda Cà Granda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy
Giovanni Magenta, Cardiologia 3, Ospedale Niguarda Cà Granda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy
Author contributions: Mancuso A designed research, performed research, contributed new reagents or analytic tools, analyzed data and wrote the paper; Martinelli L, De Carlis L, Rampoldi AG, Magenta G, Cannata A and Belli LS analyzed data.
Correspondence to: Andrea Mancuso, MD, Epatologia e Gastroenterologia, Ospedale Niguarda Ca’ Granda, Piazza Maggiore 3, 20162 Milano, Italy. andrea.mancuso@ospedaleniguarda.it
Telephone: +39-2-64444435 Fax: +39-2-64442895
Received: February 13, 2013
Revised: March 28, 2013
Accepted: May 8, 2013
Published online: May 27, 2013
Processing time: 103 Days and 11.8 Hours
Revised: March 28, 2013
Accepted: May 8, 2013
Published online: May 27, 2013
Processing time: 103 Days and 11.8 Hours
Core Tip
Core tip: We describe a novel surgical approach using a fresh caval homograft for inferior vena cava (IVC) obstruction proximal to the atrium. 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 Budd-Chiari syndrome. Further follow-up revealed progressive reduction and resolution of ascites, and overall clinical improvement.