Reconstruction of Extrapericardial Rupture of Inferior Vena Cava Without Cardiopulmonary Bypass Due to Blunt Trauma

Cavo-atrial bypass with a polytetrafluoroethylene graft for the treatment of a complete, traumatic transection of the suprahepatic inferior vena cava

In the event of injury to the vena cava, the surgeon's goal is to control the bleeding and then repair the vascular damage. Given the wide range of lesions observed, the repair step has not been standardized. There are a few case reports of simple venoplasty or cavocaval bypass with a polytetrafluoroethylene graft. The present report introduces another treatment option for total avulsion of the suprahepatic inferior vena cava when a lack of remnant venous tissue below the heart prevents direct repair: cavo-atrial bypass with a polytetrafluoroethylene graft.

A rare opportunity for conservative treatment in a case of blunt trauma to the supradiaphragmatic inferior vena cava

Injuries to the inferior vena cava (IVC) secondary to blunt trauma are rare and occur in only 1-10% of all blunt trauma patients. Management of these injuries has not been subjected to major studies, but several case reports and small retrospective studies have demonstrated that management can be tailored to the hemodynamic status of the patient; this is similar to the management of blunt liver injuries. Stable patients whose injuries have achieved local venous tamponade have been successfully treated without surgical intervention, while unstable patients require operative management. Regardless of patient status, however, IVC injuries are highly fatal with mortality rates between 70 and 90%. This report describes the case of a patient with a blunt traumatic injury to the supradiaphragmatic IVC with development of a pseudoaneurysm who was successfully managed conservatively.