Successful treatment of a blunt retrohepatic vena cava injury using an atriocaval shunt without sternotomy or thoracotomy: a case report

Abstract

Retrohepatic vena cava (RHIVC) injury is often fatal and can be very difficult to manage. Total hepatic vascular isolation, a shunt, or bypass surgery is required for the surgical treatment of RHIVC injury in hemodynamically unstable patients; however, these are not easy procedures. Here, we present a case of RHIVC injury that was successfully treated by atriocaval shunt placement via a transdiaphragmatic incision without sternotomy or thoracotomy. In addition, we review the resuscitation and surgical procedures used for total hepatic vascular isolation in patients with RHIVC injury.

Surgical Techniques for Severe Liver Injury: A Comprehensive Review of Current Approaches and Advancements

“…The retroperitoneal cavoatrial shunt involves the insertion of a tube into the right atrium through a venotomy in the infrarenal IVC, which is in contrast to the atriocaval shunt [55]. Choi et al [56] reported a case in which a retrohepatic IVC injury was successfully treated by employing atriocaval shunt placement through a transdiaphragmatic incision without sternotomy or thoracotomy. On the other hand, the retrohepatic vena cava balloon shunt entails the introduction of a dedicated balloon catheter into the retrohepatic IVC through the saphenofemoral junction [57,58].…”