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J Thorac Cardiovasc Surg 2004;126:2101-2103
© 2004 The American Association for Thoracic Surgery

Brief communication

Urgent inferior vena cava replacement with an autologous pericardium tube graft

^a Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA
^b Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Received for publication December 4, 2002; accepted for publication April 1, 2003.

^* Address for reprints: Gosta B. Pettersson, MD, The Cleveland Clinic Foundation, 9500 Euclid Ave, Desk F25, Cleveland, OH 44195, USA
petterg@ccf.org

The first 20% of the full text of this article appears below.

Surgical interventions involving the suprarenal inferior vena cava (IVC) are uncommon. They are usually required after the partial or complete resection of the IVC for the management of malignant and nonmalignant diseases.,^1,2 Three surgical techniques have been reported: patch angioplasty,,³ replacement with spiral saphenous vein graft,¹ and replacement with extended polytetrafluoroethylene (ePTFE) grafts.,^1,2,4 We report on an emergency case in which the accidentally transected suprarenal IVC was replaced with an autologous pericardial tube.

Clinical summary

A 42-year-old male man had right-sided flank pain and elevated liver enzymes. Abdominal ultrasonography and computed tomographic scan demonstrated a 5-cm right renal mass (renal cell carcinoma). Results of the metastatic workup were negative, and the patient underwent a laparoscopic right radical nephrectomy.

The laparoscopic dissection of the renal tumor was difficult and eventually complicated by severe bleeding, which could not be controlled laparoscopically. The abdomen was opened, and by manual tamponade of the undersurface of the liver and infusion of blood and intravenous fluids, blood pressure could . . . [Full Text of this Article]

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