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Ann Thorac Surg 1989;48:409-412
© 1989 The Society of Thoracic Surgeons

Articles

Transatrial Membranotomy for Budd-Chiari Syndrome

Chau-Hsiung Chang, MD*, Ming-Chung Lee, MD, Ming-Jang Shieh, MD, Jen-Ping Chang, MD, Pyng-Jing Lin, MD

Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China

Accepted for publication June 12, 1989.

* Address reprint requests to Dr Chang, Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, 199, Tun-Hwa North Rd, Taipei, Taiwan, ROC

In a 7-year period, transatrial membranotomy was performed in 11 patients with membranous obstruction of the inferior vena cava. There were 5 men and 6 women, ranging in age from 23 to 53 years. Clinical symptoms included jaundice in 4 patients, hepatomegaly in 4, leg edema or varicose veins in 10, and venous collaterals over the abdominal and chest wall in all 11 patients. Transatrial membranotomy was performed through a median sternotomy in all patients. When inferior vena cava venography revealed that the obstruction was accompanied by long segmental thrombosis, additional dilation was performed with a Hegar dilator. There was no surgical mortality. Early operative complications included pulmonary embolism in 2 patients and bleeding requiring reoperation in 1. In a mean follow-up period of 30.6 months (range, 2 to 88 months), 9 patients had no symptoms, transient pericardial constriction developed in 1 patient and resolved 1 month later, and restenosis of the inferior vena cava developed in another patient 1 year after the first operation. This latter patient received a second transatrial membranotomy followed by percutaneous balloon angioplasty of the inferior vena cava, with a satisfactory result at 8 months follow-up. We conclude that transatrial membranotomy is an effective and safe procedure for patients with membranous obstruction of the inferior vena cava.




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Home page
 Ann. Thorac. Surg.Home page
S. Victor, V. Jayanthi, and N. Madanagopalan
Membranotomy for Budd-Chiari syndrome
Ann. Thorac. Surg., September 1, 1990; 50(3): 512 - 513.
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