title: Cavoatrial bypass for occlusion of the inferior caval vein in a patient with Budd-Chiari syndrome.
abstract: We report the case of a young man with Budd-Chiari syndrome and occlusion of the inferior caval vein. Peripheral edema was his predominant complaint. Symptoms of portal hypertension were lacking, indicating membranotomy and not portosystemic shunting as the treatment of choice. At operation, membranotomy was not feasible, and a cavoatrial bypass using a 22 mm Gore-Tex graft was placed instead. Shortly after the operation the peripheral edema vanished, diuretic treatment could be withdrawn, and liver function improved. Eighteen months later the bypass remains patent, edema is absent, and liver function is stable. We conclude that cavoatrial bypass is a therapeutic option in patients with occlusion of the inferior vena cava with no clinical symptoms of portal hypertension if transcardiac membranotomy is not feasible.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital, Freiburg, Germany. wilhelm@ch11.ukl.uni-freiburg.de
authors.forename: Markus P
authors.initials: MP
authors.lastname: Wilhelm
authors.forename: Gerhard
authors.initials: G
authors.lastname: Spillner
authors.forename: Martin
authors.initials: M
authors.lastname: Rössle
authors.forename: Claudia
authors.initials: C
authors.lastname: Kurtz
authors.forename: Koppany
authors.initials: K
authors.lastname: Sarai
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Beyersdorf
mesh_terms: D000328:Adult; D001807:Blood Vessel Prosthesis; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000175:diagnosis*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011138:Polytetrafluoroethylene; D011167:Portacaval Shunt, Surgical / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000473:pathology* / Q000601:surgery
chemical_list: D011138:Polytetrafluoroethylene