Membranous obstruction of the inferior vena cava and Budd-Chiari syndrome. Report of a case.
Membranous obstruction of the inferior vena cava (MOIVC) is a rare, congenital or acquired, cause of Budd-Chiari syndrome leading to hepatocellular carcinoma in 20 to 40% of the patients. It has a very poor prognosis when treated medically and balloon angioplasty (PTA) represents, nowadays, the treatment of choice, having no mortality or significant morbidity with follow-up as long as 5 years; transatrial membranotomy, direct reconstruction of IVC and bypass surgery are alternative techniques when PTA is not feasible. One case of Budd-Chiari syndrome due to an incomplete membranous obstruction of the suprahepatic portion of the inferior vena cava is reported. A PTA was not feasible as it was not possible to pierce the membranous obstruction. A successful inferior vena cava-right atrium PTFE bypass, with a 3.5-year follow-up, was performed. This surgical approach is a valuable alternative to transatrial membranotomy and direct reconstruction of the IVC.
Zamboni
P
P
Institute of General Surgery and Vascular Laboratory, University of Ferrara, Italy.
Pisano
L
L
Mari
C
C
Galeotti
R
R
Feo
C
C
Liboni
A
A
D001807:Blood Vessel Prosthesis; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011379:Prognosis; D013927:Thrombosis / Q000150:complications / Q000601:surgery*; D014652:Vascular Diseases / Q000150:complications / Q000601:surgery; D014682:Vena Cava, Inferior
D011138:Polytetrafluoroethylene