为 Budd-Chiari 症候群的 caval 自体移植片由于劣等的静脉 cava 阻塞
A caval homograft for Budd-Chiari syndrome due to inferior vena cava obstruction作者机构：Epatologia e GastroenterologiaOspedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly CardiochirurgiaOspedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly Chirurgia Generale e dei TrapiantiOspedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly Radiologia InterventisticaOspedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly Cardiologia 3Ospedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly
出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)
年 卷 期：2013年第5卷第5期
页 面：292-295页
主 题：Budd-Chiari syndrome Inferior vena cava Occlusion Surgery Liver transplantation
摘 要：Transjugular intrahepatic portosystemic shunt (TIPS) is the standard treatment of Budd-Chiari syndrome (BCS) non responsive to medical therapy. However, patients with inferior vena cava (IVC) obstruction proximal to the atrium do not benefit from TIPS and a surgical approach is mandatory. We report the case of BCS due to intrapericardial IVC obstruction. We describe a novel surgical approach using a fresh caval homograft. An attempt to balloon dilatation of the IVC obstruction was complicated by right atrial disruption with tamponade and ventricular fibrillation. Lately, the patient successfully underwent a reconstruction of the cavo-atrial continuity by the interposition of a fresh caval homograft, a novel surgical approach never described before for BCS. Further follow-up revealed progressive reduction and resolution of ascites, and overall clinical improvement. IVC obstruction near to the atrium can be surgically approached with a new technique consisting in inferior vena cava resection and replacement with a caval homograft.
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