Veno-veno bypass of the inferior vena cava in trauma, tumor, and transplantation.
Interrupting the venous return from below the diaphragm is usually associated with sudden hypotension,
hypovolemic cardiac failure, and increased bleeding secondary to acute venous hypertension and hepatic
congestion. Shaw, Starzl, and Griffith developed a veno-veno bypass technique to shunt the somatic and
splanchnic venous return around the retrohepatic vena cava to the superior vena cava. This permitted continuation
of venous return and simultaneous blood warming, allowing surgeons to perform complex procedures in
a dry operative field. These bypass techniques have evolved since their introduction in the 1980s and are now
being applied for the removal of otherwise nonresectable tumors of the liver, adrenal gland, and kidney.
Further, traumatic injuries to the hepatic veins and the retrohepatic cava associated with a high mortality rate
can be repaired safely using vascular isolation techniques and bypass.
Gagner
R
R
University of British Columbia, Vancouver, Canada.
Scudamore
C H
CH
Buczkowski
A K
AK
Patterson
E J
EJ
Chung
S
S