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Ann Thorac Surg 1987;43:212-214
© 1987 The Society of Thoracic Surgeons

Articles

Budd-Chiari Syndrome Resulting from a Membranous Web of the Inferior Vena Cava: Operative Repair Using Profound Hypothermia and Circulatory Arrest

J. Peter Murphy, Jr., M.D., Igor Gregoric, M.D., Denton A. Cooley, M.D.*

From the Division of Cardiovascular Surgery, Texas Heart Institute of St. Luke's Episcopal Hospital, Houston, TX

Accepted for publication February 5, 1986.

* Address reprint requests to Dr. Cooley, Texas Heart Institute, P.O. Box 20345, Houston, TX 77225

A 47-year-old man was seen with Budd-Chiari syndrome caused by a congenital membranous web obstructing the inferior vena cava (IVC) above the hepatic veins. Operative repair was accomplished using cardiopulmonary bypass, profound hypothermia (24°C), and 10 minutes of circulatory arrest. This technique permitted accurate resection of the web, thorough removal of thrombus from the IVC and the hepatic veins, and repair of the atriocaval junction with an autologous pericardial patch. Postoperative angiographic study showed unobstructed flow through the IVC with filling of the hepatic veins. We believe this is the first report of use of this technique to treat Budd-Chiari syndrome resulting from a congenital web obstructing the IVC and hepatic veins.




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