PURPOSE: This report deals with the case of a patient who presented persistence of left superior vena cava (LSVC). This disorder was discovered following placement of a catheter in pulmonary artery via the left subclavian vein. CLINICAL FEATURES: The patient was a 67-yr-old woman who, while in the intensive care ...

Bullet emboli to the heart are rare and are typically treated by operative extraction through a median sternotomy and cardiotomy. This report details the case of an 18-year-old male who sustained two gunshot wounds, one of which lodged in his left renal vein. At laparotomy, the bullet embolized to the ...

RATIONALE AND OBJECTIVES: The authors evaluate in the rabbit the radiologic-pathologic changes of the inferior vena cava and the renal vein and the functional changes of the kidneys after placement of a self-expandable metallic stent in the inferior vena cava where the renal vein empties. METHODS: One self-expandable metallic stent ...

A 16-year-old male was admitted with complete occlusion of the superior vena cava pathway 14 years after Mustard procedure for transposition of the great arteries. From a left subclavian vein approach, the atretic vein segment was perforated using a straight guidewire, and was followed by sequential balloon dilation. Implantation of ...

We report a case of secondary rupture of a common iliac artery aneurysm into the common iliac vein. Exclusion of the iliac aneurysm had been performed 2 years earlier in association with reconstruction of an aortic aneurysm that had ruptured into the interior vena cava. After closure of the aortocaval ...

Catheter-related thrombotic and stenotic obstructions are the second most common serious complication of long-term total parenteral nutrition. Subsequent venous access problems have profound implications because of immediate and long-term requirements of nutrition support. Although improved understanding of pathogenesis has led to improved prophylaxis and treatment of thrombosis, some patients will ...

Deep venous thrombosis and pulmonary embolus are significant clinical problems. Although anticoagulation remains first-line therapy for thromboembolic disease, the placement of inferior vena cava filters plays an important role as alternative or supplemental therapy. Initial filters were high-profile devices intended to be placed via surgical cutdown. Concerns about the size ...

PURPOSE: To establish a new animal model of deep venous thrombosis. MATERIALS AND METHODS: Fifteen young pigs underwent temporary interruption of the inferior vena cava (IVC) below the entry of the right renal vein by means of either a silicone band (surgical technique, n = 6) or an intraluminal balloon ...

We report on a 38-year-old patient with intermittent edema of the lower legs, arms and abdominal wall. The cause for his tendency to develop edema was a membranous obstruction of the inferior vena cava and a membranous stenosis of the superior vena cava. The etiology of these anomalies of the ...

A 49-year-old woman had a vena caval filters inserted having suffered multiple pulmonary emboli and a large upper gastrointestinal bleed. She re-presented five years later with loin pain and obstructive uropathy. She was found to have a right pelvi-ureteric obstruction due to inferior vena caval wall perforation from the vena ...

OBJECTIVE: To describe the ultrasonographic appearance of the lungs, pleura, and mediastinum of cattle. DESIGN: Transcutaneous ultrasonography of the lungs and pleura was performed on the right and left sides of the thorax. The mediastinum was examined transesophageally. ANIMALS: 50 healthy cows. PROCEDURE: The thoracic wall, pleura, and pulmonary surface ...

To investigate the ketone body ratio (acetoacetate/3-hydroxybutyrate) of central venous blood compared to that of peripheral arterial blood, the acetoacetate and 3-hydroxybutyrate concentrations in paired peripheral arterial and central venous or pulmonary arterial blood were measured. The ketone body concentrations in superior and inferior vena cava blood were significantly (P ...

Computational fluid dynamic methods based on a finite-element technique were applied to the study of (1) competition of flows in the inferior and superior venae cavae in total cavopulmonary connection, and (2) competition between flow in the superior vena cava and forward flow from a stenosed pulmonary artery in bidirectional ...

Placement of percutaneous femoral venous catheters in neonates is rarely performed for long-term central venous access. We studied 44 neonates (gestational age, 32.4 +/- 48 weeks, postnatal age, 18 +/- 32 days) with lack of other venous access sites. The femoral vein was entered with a 19-gauge introducer needle with ...

A 2-year-old 2-kg female Maltese dog was referred for treatment of dirofilariosis and mild caval syndrome characterized by hemolysis and lethargy. Ultrasonography revealed worms within the caudal vena cava, right auricle, right ventricle, and pulmonary artery. Because of the mild clinical signs and small size of the dog, jugular venotomy ...

A jugular Bird's Nest filter (Cook, Bloomington, Ind) was partially deployed in the suprarenal cava for prophylaxis to prevent pulmonary embolism in a young woman with phlegmasia cerulea dolens. It was effective in capturing large emboli during thrombolysis of a loose iliocaval thrombus. It was safely removed 6 1/2 hours ...

A patient undergoing radical retroperitoneal lymphadenectomy for metastatic embryonal cell testicular carcinoma is presented. Tumor resection required removal of the inferior vena cava due to transmural invasion. The inferior vena cava was replaced using externally stented polytetrafluoroethylene (PTFE) graft. Patency was documented by postoperative Doppler studies, duplex scanning, and computed ...

In 30 normal adult livers the retrohepatic segment of inferior vena cava had a length of 6.7 cm and was totally encircled by liver substance in 30% of cases. Altogether 442 ostia venae hepaticae were found, averaging 14.7 per liver and classified as large, medium, small and minimum. The localisation ...

Stenting of the left pulmonary venous baffle obstruction was successfully performed in a 6 year old girl after the Mustard operation for transposition of the great arteries. She also had stent implantation in both the superior vena cava and inferior vena cava baffle junctions. These procedures were followed by sustained ...

We report the usefulness of transesophageal echocardiography in evaluating a patient with sclerosing mediastinitis. The technique enabled us to identify a mass obstructing the superior vena cava and right upper and lower pulmonary veins, and infiltrating and invaginating into the left atrial cavity. Transesophageal echocardiography was superior to computed tomography ...

Following traumatic injury, rapid surgical access to the airway may be required, with surgical cricothyroidostomy the procedure of choice. Immediate complications of cricothyroidostomy include unsuccessful or incorrect site of tube placement and hemorrhage. Subglottic stenosis is the most common late complication. This project was undertaken to better define the dimensions ...

During routine dissection of an 89-year-old female donor both inferior thyroid aa. as well as the left superior thyroid a. were found to be absent, whereas the right superior thyroid a. came from the right common carotid. A large lowest thyroid a. rose from the left internal thoracic a. at ...

Peripheric tumours with extension into the inferior vena cava pose difficult management problems. Venovenous bypass using a centrifugal pump to decompress the inferior vena cava may be useful adjunct during vascular isolation of the tumour. We have modified the technique by adding portal decompression to avoid visceral accumulation of toxic ...

Obstruction of the superior vena cava caused by acute aortic dissection can lead to collateral flow in the azygos and hemiazygos system, as well as to reversal of flow in the pleurohilar and bronchial veins. In the latter case, a small right-to-left shunt has formed. We describe the findings in ...

Partially unroofed coronary sinus syndrome with persistent left superior vena cava is a rare congenital anomaly. It frequently produces a right-to-left shunt. We report a case in which a large left-to-right shunt was present, because of the obstruction to left ventricular inflow as a result of the dilated coronary sinus. ...

PURPOSE: To study guide-wire engagement and entrapment by inferior vena caval (IVC) filters. MATERIALS AND METHODS: Patterns of engagement were determined in six IVC filters with four commonly used guide wires in a simulated IVC. Force required to disengage guide wires from filters was measured. RESULTS: Eleven engagement patterns were ...

Absence of the inferior vena cava (IVC) is an uncommon congenital abnormality. Symptoms of lower extremity venous insufficiency resulting from this anatomic abnormality have been reported only once in the English literature, and no experience with surgical treatment of this condition has been published. We report the case of an ...

We report herein the cases of two patients with major venous anomalies associated with abdominal aneurysmectomy, one being an isolated left-sided vena cava and the other, a retroaortic left renal vein, and discuss the clinical significance of such anomalies. In the first patient, an isolated left-sided vena cava was correctly ...

Intrahepatic and/or extrahepatic collateral pathways result from the membranous obstruction of the inferior vena cava. These collaterals are usually insufficient to prevent Budd-Chiari syndrome. We reprot an unusual case of asymptomatic membranous obstruction of the inferior vena cava in which marked intrahepatic collateral pathways were formed. Although the inferior vena ...

OBJECTIVE: To assess the value of Doppler indices, calculated from fetal arterial peripheral vessels, cardiac outflow tracts and venous vessels, in the identification of acidaemia, hypercapnia and hypoxaemia as determined by pH and gas analysis of fetal blood obtained by cordocentesis in growth retarded fetuses. DESIGN: Doppler measurements were taken ...

Operative retrieval of two proximally migrated vena caval filters was performed in two patients, ages 42 and 45 years, respectively. In the first patient the filter was encrusted in the right ventricle, and in the second one the filter was found in the pulmonary artery. Both filters were retrieved under ...

OBJECTIVE: To describe unusual venous communications from the right to the left atrium resulting in cyanosis after the modified Fontan procedure, and their management with transcatheter occlusion. METHODS: Between September 1992 and November 1994, eight patients were assessed for persistent cyanosis after a modified Fontan procedure. Desaturation was found to ...

We present a rare case of an extensive venous thrombosis associated with a multisegmental anomaly of the inferior vena cava (IVC), double IVCs, a hypoplastic right IVC, an aneurysm arising at the distal portion of the right IVC, and a severe stenosis between the prerenal and the hepatic segments of ...

PURPOSE: To report the first case of a potentially catastrophic complication of vena caval interruption with a bird's nest filter. METHODS AND RESULTS: A 55-year-old Saudi patient presented with hypovolemic shock from massive upper gastrointestinal hemorrhage. Endoscopy identified a metallic object penetrating the duodenum. Five years earlier, the patient had ...

Gaining access for vena cavography may be difficult in patients with multiple venous occlusions. We report the use of selective azygous venography to demonstrate potency of the proximal inferior vena cava (IVC) when no alternative route was available and noninvasive techniques were not applicable. The proximal superior vena cava and ...

An eight-month-old, male domestic shorthair kitten developed progressive abdominal distension over a six-week period. Abdominocentesis revealed a fluid with high protein (3.8 g/dl) and moderate cellularity. Infectious, cardiovascular, and neoplastic causes of posthepatic obstruction were ruled out. Partial obstruction and stenosis of the caudal vena cava (CVC) at the level ...

Two patients with dissimilar but advanced malignancies and lower extremity swelling underwent bilateral lower extremity radionuclide venograms, several months apart. Both patients' scintigrams showed multiple collaterals in the abdomen and pelvis, consistent with inferior vena cava obstruction, and hepatic uptake in a diffuse pattern. One patient also had multiple bilateral ...

PURPOSE: To establish the influence of number of emboli on the trapping ability of vena cava filters in vitro. MATERIALS AND METHODS: Three filters, the titanium Greenfield, Vena Tech-LGM, and Günther Tulip retrievable, were studied with use of 20- or 26-mm-diameter tubes to simulate the inferior vena cava. In the ...

A 40-year-old woman presented with facial swelling and pressure sensation of the ears and sinuses. Chest roentgenography revealed a right paratracheal mass, which was confirmed by a venogram, and transjugular biopsy showed low-grade leiomyosarcoma. The superior vena cava was resected and reconstructed using a spiral vein graft. Pathologic evaluation revealed ...

Cardiac musculature of the cranial vena cava in the common tree shrew (Tupaia glis) was examined by light and transmission electron microscopy. The common tree shrew has well developed cardiac myocyte layers in the tunica media of the cranial vena cava, extending from the right atrium to the root of ...

PURPOSE: To test a new filter design that allows coaxial insertion of thrombectomy devices and active clot removal. MATERIALS AND METHODS: A prototype filter system was used in animal experiments. It is a transjugularly inserted coaxial system with a 16-F outer sheath and an inner tube that is covered by ...

A 70-year old man with a history of anorexia, weight loss, and progressive shortness of breath was studied by transesophageal echocardiography. In addition to a mass occupying the right ventricular outflow tract, a rare congenital heart anomaly was discovered serendipitously: persistent left superior vena cava, absent right superior vena cava, ...

Total cavopulmonary connection with use of an autogenous intraatrial tunnel to create a straight tube between the inferior vena cava and the pulmonary artery was attempted in several types of cardiac anomaly in eight consecutive candidates for the Fontan operation. A small right atrium with an extraordinary location of the ...

We describe the problems of clinical assessment of subclavian catheter placement whose course was noted to be along the left lateral border of the heart, suggesting malposition. After the catheter's position in a persistent left superior vena cava was confirmed by blood gas analysis, lateral chest X-ray film, and venography, ...

A modified technique for the Fontan operation is described in which an adjustable communication between the extracardiac conduit (systemic venous chamber) and the right atrium (pulmonary venous chamber) is constructed. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, ...

To facilitate the preoperative diagnosis and surgical management of visceral heterotaxy and asplenia, 72 postmortem cases were reviewed with particular attention focused on the systemic and pulmonary venous connections. The superior vena cava was bilateral in 51 cases (71%), but in 9 cases one of the superior venae cavae was ...

The co-existence of abnormalities of the inferior vena cava (IVC) and abdominal aortic aneurysm (AAA) is a rare condition but with surgical significance. With the development of various imaging technics and the routine use of computerized tomography for the examination of the abdomen and/or the investigation of AAA these venous ...

The authors report the history of a 35-year-old man who was operated on because of an asymptomatic combined membranous obstruction and saccular aneurysm of the inferior vena cava (IVC) at diaphragmatic level. Using extracorporeal circulation as well as hypothermia, aneurysm and IVC obstruction were resected and the IVC reconstructed using ...

A two-year-old labrador retriever was examined after a year's history of persistent ascites and exercise intolerance that began shortly after the dog was struck by an automobile. Contrast venography showed tortuosity of the intrathoracic caudal vena cava with partial obstruction caused by kinking of the vessel. Surgical resection of a ...

Over a 16 month period seven patients underwent surgery using venous allografts either to reconstruct the portal vein, or to construct a mesocaval 'H' graft or a shunt between the coronary vein and the subhepatic inferior vena cava. The allografts were harvested during multiorgan procurement from the bifurcation of the ...