title: Maintaining long-term central venous access by repetitive hepatic vein cannulation.
abstract: Long-term central venous access has become a critical issue in the treatment of pediatric patients. Exhaustion of access sites can lead to superior and inferior vena cava thrombosis, limiting the choices for central line placement. Under such circumstances, hepatic vein cannulation is a viable option. We present the cases of two patients who, combined, have undergone five hepatic vein catheterizations. One patient has received four consecutive central lines via a hepatic vein. This experience suggests that the hepatic vein is a reusable site of cannulation in patients with no other alternative for venous access.
authors.affiliation: Division of Pediatric Surgery, Children's Hospital of Los Angeles, CA 90027.
authors.forename: J
authors.initials: J
authors.lastname: de Csepel
authors.forename: P
authors.initials: P
authors.lastname: Stanley
authors.forename: E M
authors.initials: EM
authors.lastname: Padua
authors.forename: J B
authors.initials: JB
authors.lastname: Atkinson
mesh_terms: D002405:Catheterization, Central Venous / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006503:Hepatic Veins; D006801:Humans; D008297:Male; D010289:Parenteral Nutrition, Total / Q000379:methods; D012778:Short Bowel Syndrome / Q000628:therapy