A cylindrical femoral vein panel graft for caval reconstructions

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Presentation transcript:

A cylindrical femoral vein panel graft for caval reconstructions Derek A. DuBay, MD, Thomas Lindsay, MD, Carol Swallow, MD, PhD, Ian McGilvray, MD, PhD Journal of Vascular Surgery Volume 49, Issue 1, Pages 255-259 (January 2009) DOI: 10.1016/j.jvs.2008.08.001 Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 1 Diagram depicting how the donor vein is divided longitudinally (A), and then halved (B). The smaller distal end is aligned with the larger proximal end to create a construct with a constant luminal diameter (C and D). The use of several “stay” sutures is quite helpful to maintain the position of the graft (C). Performing the final anastomosis around a chest tube helps create a constant luminal diameter (E). Journal of Vascular Surgery 2009 49, 255-259DOI: (10.1016/j.jvs.2008.08.001) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 2 Computed tomography view of a patient with a recurrent fibrosing retroperitoneal liposarcoma involving a long segment of the vena cava as well as the duodenum and pancreatic head. Journal of Vascular Surgery 2009 49, 255-259DOI: (10.1016/j.jvs.2008.08.001) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 3 Intraoperative photo demonstrating a completed cylindrical SFV panel graft replacement of the vena cava from the takeoff of the left renal vein to the iliac bifurcation. Journal of Vascular Surgery 2009 49, 255-259DOI: (10.1016/j.jvs.2008.08.001) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 4 Computed tomography (sagittal) view of the in situ graft replacement of the vena cava. The vena cava is somewhat displaced to the right of the vertebral bodies. Note the maintenance of vena cava luminal diameter. This patient had a partial duodenectomy and a segmental jejunal resection performed in concert with the vena cava resection/reconstruction. The duodeno-jejunostomy and jejuno-jejunostomy anastomoses are immediately adjacent to the autogenous graft construct. The arrows represent the approximate sites of the upper and lower caval anastomoses. Journal of Vascular Surgery 2009 49, 255-259DOI: (10.1016/j.jvs.2008.08.001) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions