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Journal articles on the topic 'CAVAL'

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Author: Grafiati

Published: 4 June 2021

Last updated: 11 February 2022

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1

Belgrano, E., C. Trombetta, G. Liguori, S. Siracusano, L. Buttazzi, and B. Zincone. "Ricostruzione cavale con patch di vena ovarica in un caso di adenocarcinoma renale con trombosi cavale intraepatica." Urologia Journal 64, no. 1_suppl (January 1997): 26–28. http://dx.doi.org/10.1177/039156039706401s05.

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We report a case of caval reconstruction with ovarian vein patch in a patient suffering from renal adenocarcinoma with intrahepatic caval thrombosis. The size of the patch was 5×1.5 cm, allowing a cavai gauge of 2 cm to be obtained. The use of autologous material for caval reconstruction is a common technique with fewer complications than with heterologous material.

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2

Shah, Bhupesh D., Deena Shah, Sakuntala Calla, Mehul Shah, and Varsha Shah. "Control of Persistent Inferior Vena Caval Bleeding." Asian Cardiovascular and Thoracic Annals 8, no. 2 (June 2000): 178–79. http://dx.doi.org/10.1177/021849230000800223.

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A technique to control inferior vena caval bleeding by clockwise rotation of the inferior vena cava after skeletization, is described. This gave excellent hemostatic control and the inferior vena cava was stitched in this position. On follow-up, there was no evidence of compromised inferior vena caval drainage.

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3

Dandolu, Reddy, Douglas Eaton, Aras Ali, Nannette Schwann, and Andrew Wechsler. "Right Atrial Surgery without Caval Snaring." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 1, no. 2 (December 2005): 75–78. http://dx.doi.org/10.1097/01243895-200500120-00004.

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Background During tricuspid valve replacement in a patient with previous mitral valve surgery, we made an incidental observation that the right atrium can be opened without caval snaring and without air entering the venous reservoir. We tested this hypothesis on an animal model. Methods Two patients underwent right atrial surgery using percutaneous cannulation, and no air was entrained without caval snaring. This principle was tested in an animal model using 2 pigs weighing 80 kg each. Percutaneous cannulae were placed under epicardial echo guidance with their tips 4 cm from the right atrium. A “collapsible bag with air drainage system” was introduced into the venous return system to quantify air return from the superior vena cava (SVC) and inferior vena cava (IVC). Two types of percutaneous cannulae with (Cardiovations Quick Draw) and without (Biomedicus) proximal side holes were tested. Results In the animal model using Biomedicus cannulae, upon opening the right atrium, air was entrained from the SVC cannula at 60 mL/minute with no air in the IVC. There was no difference in the amount of air between the two cannulae. Pressures measured were 5 cm of water in the IVC and −20 cm water in the SVC. Epicardial ultrasound demonstrated complete collapse of both vena cavae. Partial clamping of the SVC cannula reduced the amount of air to 60 cc/min, and placing a small straight clamp at the SVC atrial junction eliminated the air. No air was noted in IVC cannula. Conclusions Inferior vena caval drainage by percutaneous cannula does not entrain air with either type of cannula and without snaring (both in clinical cases and animal model). This might be explained by the presence of a competent Eustachian valve. However, the SVC is not immune to air. Minimal air (approximately 60 mL/minute) could be managed by partial clamping or completely be avoided by placing a small straight clamp without snaring.

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4

Friedland, Mark, Andris Kazmers, Ronald Kline, Harvey Groehn, Chris Meeker, Susan Despriet, Katherine Abson, and Gail Oust. "Vena cava duplex imaging before caval interruption." Journal of Vascular Surgery 24, no. 4 (October 1996): 608–13. http://dx.doi.org/10.1016/s0741-5214(96)70076-9.

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5

Jia, Zhongzhi, Alex Wu, Mathew Tam, James Spain, J. Mark McKinney, and Weiping Wang. "Caval Penetration by Inferior Vena Cava Filters." Circulation 132, no. 10 (September 8, 2015): 944–52. http://dx.doi.org/10.1161/circulationaha.115.016468.

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6

Proctor, Mary C., Lazar J. Greenfield, Kyung J. Cho, Mohammed M. Moursi, and Eric A. James. "Assessment of Apparent Vena Caval Penetration by the Greenfield Filter." Journal of Endovascular Therapy 5, no. 3 (August 1998): 251–58. http://dx.doi.org/10.1177/152660289800500311.

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Purpose: To examine and elucidate the mechanisms for apparent “penetration” by Greenfield vena caval filters. Methods: Two filters were placed in the inferior venae cavae (IVC) of four immature sheep and followed with cavography for 1 year. Two animals underwent computed tomography (CT) and laparoscopic examination. At necropsy, the vena cava and adjacent structures of all four animals were examined grossly and histologically. Results: Based upon cavography and CT imaging, all filters appeared to penetrate the vena cava at 12 months. However, at laparoscopy, no hooks or limbs were exposed, and the pericaval tissues remained intact; each hook or limb was within the adventitia or encapsulated in scar tissue. Histology of the tissue at the hook sites revealed remodeling of the intimal surface of the IVC and thinning of the adventitia. Conclusions: Based upon these data, we hypothesize that the vena cava gradually adapts by medial and adventitial thinning and myointimal remodeling to the radial force exerted by a filter. This process allows increase in the filter base diameter while maintaining the integrity of the cava and protecting adjacent structures.

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7

Siow, Jia Wen, QiCai Jason Hoon, Elizabeth Jenkins, Nikola Heblinski, and Mariano Makara. "Caval foramen hernia in a cat." Journal of Feline Medicine and Surgery Open Reports 6, no. 2 (July 2020): 205511692096402. http://dx.doi.org/10.1177/2055116920964021.

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Case summary A 3-year-old neutered female domestic shorthair cat presented for a 2-week history of hyporexia, lethargy and weight loss. Aspartate aminotransferase, alanine aminotransferase and cholesterol were mildly elevated. Thoracic radiographs identified a lobulated soft tissue opacity in the caudal thorax to the right of midline, with the border effacing the caudal vena cava and broad-based towards the diaphragm. The broad base was suggestive of diaphragmatic hernia, with the other radiographic features and location suggestive of caval foramen hernia. Ultrasound confirmed diaphragmatic hernia with liver herniation. CT showed the herniation of multiple liver lobes and the gallbladder through a defect at the caval foramen. Herniorrhaphy was performed via ventral midline coeliotomy. Following this procedure, the cat’s clinical signs resolved and its weight has been regained. Relevance and novel information To our knowledge, this is the first report of successful caval foramen herniorrhaphy in a cat. Caval foramen hernia is a type of congenital diaphragmatic hernia. The authors suggest that its embryopathology involves defective septum transversum development. The case was detected during the standard diagnostic investigation of non-specific clinical signs. Its radiographic findings may easily be mistaken for a pulmonary mass. Although not seen in our case, caval foramen hernia is commonly associated with caudal vena cava obstruction, which can potentially result in Budd–Chiari-like syndrome.

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8

Iezzi, Roberto, Alessandro Posa, Francesca Carchesio, and Riccardo Manfredi. "Multidetector-row CT imaging evaluation of superior and inferior vena cava normal anatomy and caval variants: Report of our cases and literature review with embryologic correlation." Phlebology: The Journal of Venous Disease 34, no. 2 (May 11, 2018): 77–87. http://dx.doi.org/10.1177/0268355518774964.

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Objective To assess the potential of multidetector-row computed tomography imaging and its reformations in the evaluation of the superior and inferior vena cava normal anatomy and their anatomical variants, and to make a brief review of caval embryogenesis and developmental errors. Methods We retrospectively reviewed a total of 1000 whole-body computed tomography scans performed between January 2010 and December 2016 to assess the normal superior and inferior vena cava anatomy and their variants. Results The normal superior and inferior vena cava anatomy was found in 88.9% of patients, whereas multiple variants were found, ranging from the superior or inferior vena cava duplication, to the azygos continuation of the inferior vena cava. Conclusions Computed tomography is a powerful tool to analyse superior and inferior vena cava anatomical variants. The knowledge and assessment of normal caval anatomy and of its anatomical variants is mandatory in the correct pre-operative planning in surgical and radiological interventions. Knowledge of caval variants is helpful in the differential diagnosis of abdominal or mediastinal masses, to avoid misdiagnosis, as well as in the screening of associated congenital pathologic conditions.

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9

Rajakulasingam, Ramyah, Rohin Francis, and Ramanan Rajakulasingam. "Vena Caval Anomalies." Journal of Clinical Imaging Science 3 (November 28, 2013): 51. http://dx.doi.org/10.4103/2156-7514.122319.

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Anomalous vena cavae can have significant implications for procedures on the right side of the heart. We report a rare anatomical configuration in a 44-year-old female, which to the best of our knowledge, is the first report of such an association. She had a bicuspid aortic valve in conjunction with a persistent left superior vena cava (PLSVC) draining into the coronary sinus, and a left-sided inferior vena cava (IVC) draining into a left superior vena cava via the hemiazygos vein. Comprehensive assessment of these anomalies is crucial given the widespread use of invasive cardiac procedures.

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10

Grindstaff, Regina R., Ryan J. Grindstaff, and J. Thomas Cunningham. "Effects of right atrial distension on the activity of magnocellular neurons in the supraoptic nucleus." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 278, no. 6 (June 1, 2000): R1605—R1615. http://dx.doi.org/10.1152/ajpregu.2000.278.6.r1605.

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A small balloon placed at the junction of the superior vena cava and right atrium was used to stimulate cardiac volume receptors in pentobarbital sodium-anesthetized male rats. Extracellular recordings were obtained from antidromically identified vasopressinergic and oxytocinergic neurosecretory cells of the supraoptic nucleus. Cells were considered sensitive to the stimulus if balloon inflation resulted in a 30% change in firing frequency. Balloon inflation that did not stretch the caval-atrial junction had no significant effect on vasopressin neurons ( n = 51, P > 0.05). Stretch of the caval-atrial junction decreased the firing activity in 64 of 83 putative vasopressin neurons ( P < 0.01 compared with control). Stretch of the caval-atrial junction influenced the firing activity of only 3 of 26 antidromically activated oxytocinergic neurons, an effect not statistically different from control ( P> 0.05). When bilateral vagotomy was performed while recording from vasopressin neurons ( n = 5), sensitivity to stretch of the caval-atrial junction was eliminated. Cardiac receptors located at the junction of the superior vena cava and right atrium may be important in regulating the activity of vasopressinergic but not oxytocinergic neurons of the supraoptic nucleus.

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11

Murray, John D., M. Lynne O’Sullivan, and Kimberley C. E. Hawkes. "Cranial Vena Caval Thrombosis Associated With Endocardial Pacing Leads in Three Dogs." Journal of the American Animal Hospital Association 46, no. 3 (May 1, 2010): 186–92. http://dx.doi.org/10.5326/0460186.

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Three dogs were examined several years following implantation of transvenous, single-lead, endocardial, right-ventricular permanent pacing systems for signs consistent with cranial vena caval syndrome. Angiograms performed in all dogs revealed filling defects within the cranial vena cava and, in some instances, intracardiac filling defects. Medical therapy was instituted in two dogs, with one surviving several weeks. One dog underwent surgery to address intra-cardiac thrombosis but did not survive the immediate postoperative period. Postmortem examinations were performed in two dogs and confirmed cranial vena caval and intracardiac thrombosis. Cranial vena caval thrombosis associated with transvenous pacing leads appears to carry significant morbidity and mortality.

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12

SIRACUSANO, S., G. LIGUORI, M. ZANON, C. TROMBETTA, and F. ZANCONATI. "Caval leiomyosarcoma." BJU International 80, no. 5 (November 1997): 827–28. http://dx.doi.org/10.1046/j.1464-410x.1997.00391.x.

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13

Redhead, D. N. "Caval filters." British Journal of Surgery 81, no. 8 (August 1994): 1089–90. http://dx.doi.org/10.1002/bjs.1800810802.

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14

Rosenfeld, K., and R. Dick. "Caval halo." British Journal of Radiology 69, no. 825 (September 1996): 883. http://dx.doi.org/10.1259/0007-1285-69-825-883.

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15

Lemmon, Gary W., Lawrence J. Litscher, and Gary W. Lemmon. "Incomplete Caval Protection Following Suprarenal Caval Filter Placement." Angiology 51, no. 2 (February 2000): 155–59. http://dx.doi.org/10.1177/000331970005100209.

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16

Cina, A., G. Masselli, C. Di Stasi, L. Natale, A. R. Cotroneo, G. Cina, and L. Bonomo. "Computed tomography imaging of vena cava filter complications: a pictorial review." Acta Radiologica 47, no. 2 (March 2006): 135–44. http://dx.doi.org/10.1080/02841850500447203.

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Caval filters are widely used in the prevention of pulmonary embolism. Filters have proved to be effective, but the complication rate is not negligible. Computed tomography (CT) provides a complete evaluation of the filter, including both caval and extracaval complications. In this review, we describe the normal CT aspect of cava filters, the classification of complications and their CT findings. Technical considerations for adequate CT imaging are also highlighted.

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17

Howard, J., KA Arceneaux, B. Paugh-Partington, and J. Oliver. "Blastomycosis granuloma involving the cranial vena cava associated with chylothorax and cranial vena caval syndrome in a dog." Journal of the American Animal Hospital Association 36, no. 2 (March 1, 2000): 159–61. http://dx.doi.org/10.5326/15473317-36-2-159.

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A four-year-old, sexually intact, male dachshund was diagnosed with pulmonary blastomycosis. Itraconazole was administered for 60 days, and the dog was considered to be disease-free at three- and 12-month reevaluations. Two years following discontinuation of itraconazole, the dog developed a granuloma of the cranial vena cava resulting in chylothorax and cranial vena caval obstruction. To the authors' knowledge, this is the first case of a blastomycotic granuloma involving the vena cava reported in the dog. Blastomycosis should be considered as a differential diagnosis for both chylothorax and cranial vena caval syndrome in the dog.

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18

Cheng, Linong, and Andrew J. Rankin. "Problems associated with the measurement of mean circulatory filling pressure by the atrial balloon technique in anaesthetized rats." Canadian Journal of Physiology and Pharmacology 70, no. 2 (February 1, 1992): 233–39. http://dx.doi.org/10.1139/y92-029.

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To examine the existence of pressure equilibrium between tributary veins and the central vena cava during the mean circulatory filling pressure manoeuvre, pressures in the hepatic portal vein, renal vein, and inferior vena cava were determined at 4-s intervals over a 20-s period of circulatory arrest induced by inflating a right atrial balloon in normal blood volume, 10% volume depletion, and 10% volume expansion states in urethane-anaesthetized rats. Portal vein pressure determined 8 s after arrest during volume depletion and expansion was significantly higher than vena caval pressure (6.2 ± 0.8 vs. 3.4 ± 0.2 and 7.7 ± 0.5 vs. 6.2 ± 0.4 mmHg (1 mmHg = 133.32 Pa), respectively; p < 0.01): this pressure disequilibrium continued for 16 s during volume expansion and for the entire 20 s during volume depletion. Renal vein pressure was equal to vena caval pressure during this manoeuvre. Portal vein pressure at normal blood volume was not significantly different from vena caval pressure following circulatory arrest (4.6 ± 0.3 vs. 3.8 ± 0.4 mmHg, respectively). Following ganglionic blockade, portal vein pressure was still significantly higher than vena caval pressure for 12 s during volume alterations. At the 8th s of the arrest the portal pressure determined in volume depletion was 3.6 ± 0.3 mmHg and the inferior vena caval pressure was 2.6 ± 0.4 mmHg (p < 0.05). Under the volume expansion condition, the respective values were 6.5 ± 0.3 and 5.3 ± 0.4 mmHg (p < 0.05). We conclude that, under conditions of blood volume alterations, there is no pressure equilibrium between the portal vein and the inferior vena cava when mean circulatory filling pressure is measured by this technique; a transhepatic barrier independent of reflex control during the measurement of mean circulatory filling pressure appears to play a role in obstructing the establishment of pressure equilibrium within the venous system.Key words: mean circulatory filling pressure, vascular capacitance, hepatic portal vein pressure, unstressed volume.

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19

Santhanakrishnan, Arvind, Kevin O. Maher, Elaine Tang, Reza H. Khiabani, Jacob Johnson, and Ajit P. Yoganathan. "Hemodynamic effects of implanting a unidirectional valve in the inferior vena cava of the Fontan circulation pathway: an in vitro investigation." American Journal of Physiology-Heart and Circulatory Physiology 305, no. 10 (November 15, 2013): H1538—H1547. http://dx.doi.org/10.1152/ajpheart.00351.2013.

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The Fontan surgical procedure used for treating patients with single ventricle congenital heart disorders results in a total cavopulmonary connection (TCPC) of the vena cavae to the pulmonary arteries (PAs). Sluggish TCPC flow and elevated hepatic venous pressures are commonly observed in this altered physiology, which in turn can lead to long-term complications including liver congestion and cirrhosis. The hypothesis of this study is that placement of a unidirectional valve within the inferior vena cava (IVC) will improve hemodynamics of the Fontan circulation by preventing retrograde flow and lowering hepatic venous pressure. An in vitro experimental setup consisting of an idealized TCPC model with flexible walls was used for investigation, and a bovine venous valve was inserted in the IVC below the TCPC. Pressure fluctuations were introduced in the flow through the model to simulate venous pulsatility. Hemodynamics of baseline and valve-implanted conditions were compared across total caval flows ranging from 1.0 to 2.5 l/min with varying caval flow distributions. The results indicated that valve closure occurred for 15–20% of the total cycle, with consequent reduction in the upstream hepatic venous pressure by 5 to 10 mmHg. Energy loss (EL) through the TCPC was lowered with valve implantation to 20–50% of baseline, occurring across all flow conditions considered with mean caval and PA pressures greater than 10 mmHg. The results of this in vitro modeling suggest that IVC valve placement has the potential to improve hemodynamics in the Fontan circulation by decreasing hepatic venous hypertension and EL.

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20

Gordon, Sarah, Tamie Kerns, William Londeree, and Brian Ching. "Idiopathic Thrombosis of the Inferior Vena Cava and Bilateral Femoral Veins in an Otherwise Healthy Male Soldier." Case Reports in Medicine 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/246201.

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Thrombosis of the inferior vena cava is less common than deep venous thrombosis of the lower extremities, particularly in the absence of an obvious congenital caval abnormality or hypercoagulable state. We present a case of IVC thrombosis in an otherwise healthy and active 28-year-old male soldier secondary to dehydration and venous webbing. IVC thrombosis is an uncommon and underrecognized condition; in this case, the patient’s caval thrombosis was initially mistaken for acute back strain. Prompt recognition is necessary to minimize long-term sequelae.

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21

Cheng, Danny, and Steven M. Zangan. "Duplication of the Inferior Vena Cava in a Patient Presenting for IVC Filter Placement." Journal of Vascular Access 11, no. 2 (April 2010): 162–64. http://dx.doi.org/10.1177/112972981001100215.

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Given the complex embryogenesis of the inferior vena cava (IVC), anatomic variations are commonly encountered. Duplication of the IVC occurs in up to 2.8% of the population. Though asymptomatic, a duplicated IVC has important clinical implications when attempting caval filtration. We present the case of a 45- year-old male with factor V leiden and protein C deficiency, who required cessation of warfarin anticoagulation in preparation for cervical laminectomy. The patient had a duplicated IVC and required placement of a caval filter in each IVC.

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22

Grieff, Anthony N., Charles Hamilton, Justin Ady, William E. Beckerman, Randy Shafritz, Vadim Koshenkov, and Saum Rahimi. "Concomitant Aorto-Caval Reconstruction for Inferior Vena Cava Leiomyosarcoma." Annals of Vascular Surgery 70 (January 2021): 567.e13–567.e17. http://dx.doi.org/10.1016/j.avsg.2020.08.011.

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23

Holleck, Jürgen L., Eric Y. Chen, and Jason Bonomo. "Caval Perforation from a Malpositioned Inferior Vena Cava Filter." Journal of General Internal Medicine 34, no. 7 (April 10, 2019): 1358–59. http://dx.doi.org/10.1007/s11606-019-04933-8.

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24

Alkhouli, Mohamad, Irfan Shafi, and Riyaz Bashir. "Inferior Vena Cava Filter Thrombosis and Suprarenal Caval Stenosis." JACC: Cardiovascular Interventions 8, no. 2 (February 2015): e23-e25. http://dx.doi.org/10.1016/j.jcin.2014.09.021.

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25

Brodmann, Gary, and Pilger. "Massive pulmonary embolism in spite of temporary vena caval filter." Vasa 39, no. 1 (February 1, 2010): 111–14. http://dx.doi.org/10.1024/0301-1526/a000014.

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Anticoagulation still remains the primary therapy for venous thromboembolism (VTE) in order to prevent the most life-threatening form of VTE, pulmonary embolism (PE). Nevertheless in some patients anticoagulation is impossible. Then vena caval filters serve as a valuable second line therapy against the most feared complication of VTE, fatal PE. We want to present a patient with preceding PE and DVT in whom for the perioperative period a temporary vena caval filter was placed and who showed the complication of a nearly fatal PE. A seventy-two year-old white male was admitted for thrombolytic therapy for massive pulmonary embolism, which was performed successfully. Some hours later the patient developed gastrointestinal bleeding. An adenocarcinoma of the colon was diagnosed and an end-to-end hemicolectomy performed. A temporal caval filter (Gunther filter) was placed in the infrarenal vena cava for the perioperative period. Seven days later the patient syncopated with acute massive onset of dyspnea. A helix computertomography scan of the lung showed again massive central pulmonary embolism with right heart enlargement. An immediate pulmonary embolectomy had to be performed. Subsequent venal cavography revealed a thrombosed vena caval filter and a thrombus proximal to the filter. This case report should emphasize the fact that although a vena cava filter might be of high benefit in patients with contraindication for anticoagulation to prevent recurrent PE, in some cases it can be insufficient and lead to enormous complications.

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26

Streiff, Michael B. "Vena caval filters: a comprehensive review." Blood 95, no. 12 (June 15, 2000): 3669–77. http://dx.doi.org/10.1182/blood.v95.12.3669.

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Abstract Hematologists are often asked to treat patients with venous thromboembolic disease. Although anticoagulation remains the primary therapy for venous thromboembolism, vena caval filters are an important alternative when anticoagulants are contraindicated. To assess the evidence supporting the utility of these devices, a comprehensive review of the English language literature was performed. Except for one randomized trial, the vena caval filter literature consists of case series or consecutive case series. The mean duration of follow-up for each of the 5 filter types varies from 6 to 18 months. All are about equally effective in the prevention of pulmonary embolism (2.6%-3.8%). Deep venous thrombosis (6%-32%) and inferior vena cava thrombosis (3.6%-11.2%) after filter placement vary widely among different filter types primarily because of differences in outcome assessment. Thrombosis at the insertion site is a common complication of filter placement (23%-36%). In view of the absence of randomized comparisons, no filter can be designated as superior in safety or efficacy. Vena caval filters represent a potentially important but poorly evaluated therapeutic modality in the prevention of pulmonary emboli. Randomized trials are necessary to establish the appropriate place for vena caval filters in the treatment of venous thromboembolic disease.

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Streiff, Michael B. "Vena caval filters: a comprehensive review." Blood 95, no. 12 (June 15, 2000): 3669–77. http://dx.doi.org/10.1182/blood.v95.12.3669.012k49_3669_3677.

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Hematologists are often asked to treat patients with venous thromboembolic disease. Although anticoagulation remains the primary therapy for venous thromboembolism, vena caval filters are an important alternative when anticoagulants are contraindicated. To assess the evidence supporting the utility of these devices, a comprehensive review of the English language literature was performed. Except for one randomized trial, the vena caval filter literature consists of case series or consecutive case series. The mean duration of follow-up for each of the 5 filter types varies from 6 to 18 months. All are about equally effective in the prevention of pulmonary embolism (2.6%-3.8%). Deep venous thrombosis (6%-32%) and inferior vena cava thrombosis (3.6%-11.2%) after filter placement vary widely among different filter types primarily because of differences in outcome assessment. Thrombosis at the insertion site is a common complication of filter placement (23%-36%). In view of the absence of randomized comparisons, no filter can be designated as superior in safety or efficacy. Vena caval filters represent a potentially important but poorly evaluated therapeutic modality in the prevention of pulmonary emboli. Randomized trials are necessary to establish the appropriate place for vena caval filters in the treatment of venous thromboembolic disease.

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28

Sharda, Rajan, Raymond Deutscher, Chris Christodoulou, David Horne, Darren H. Freed, and Thomas McGregor. "Unanticipated intra-operative finding of pulmonary artery tumour thromboembolism during radical nephrectomy and caval thrombectomy: Case report and management." Canadian Urological Association Journal 7, no. 5-6 (May 13, 2013): 381. http://dx.doi.org/10.5489/cuaj.1224.

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We report a case of an unanticipated intra-operative transesophageal echocardiography (TEE) finding of pulmonary artery thromboembolism in a 72yr woman being prepared for radical nephrectomy and caval thrombectomy. Intra-operative TEE performed to evaluate the extent of caval thrombus found the presence of pulmonary artery tumor thromboembolism in an otherwise asymptomatic patient after induction and prior to commencing surgery. A chest Computed Tomography (CT) scan confirmed a large saddle tumor thromboembolus. A multidisciplinary approach was utilized to facilitate radical nephrectomy with caval thrombectomy and pulmonary artery thromboembolectomy. This case shows the importance of adequate perioperative imaging and utilization of intra-operative TEE to evaluate the extent of disease. To our knowledge, we are the first to present a case of RCC with cava tumour thrombus in which the pulmonary artery tumour thromboembolism was detected incidentally on intraoperative TEE.

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29

McCowan, Timothy C. "Vena Caval Filters." Journal of Vascular and Interventional Radiology 7, no. 1 (January 1996): 334–37. http://dx.doi.org/10.1016/s1051-0443(96)70117-3.

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30

McCowan, Timothy C. "Vena Caval Filters." Journal of Vascular and Interventional Radiology 9, no. 1 (January 1998): 151–54. http://dx.doi.org/10.1016/s1051-0443(98)70083-1.

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31

Atici, Atilla G., Serhat Findik, Richard W. Light, Sevket Ozkaya, Levent Erkan, and Huseyin Akan. "Vena caval thromboses." Journal of Critical Care 25, no. 2 (June 2010): 336–42. http://dx.doi.org/10.1016/j.jcrc.2009.09.006.

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32

Schulder, M., A. Hirano, and C. Elkin. "???Caval-septal??? hematoma." Neurosurgery 21, no. 2 (August 1987): 239???41. http://dx.doi.org/10.1097/00006123-198708000-00021.

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33

Davidovic, L. "Aorto-caval fistulas." Cardiovascular Surgery 10, no. 6 (December 2002): 555–60. http://dx.doi.org/10.1016/s0967-2109(02)00106-0.

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34

Geoghegan, Tony, Thara Persaud, Helen O'Grady, Sean Tierney, and William C. Torreggiani. "Aorto-caval fistula." British Journal of Hospital Medicine 66, no. 7 (July 2005): 425. http://dx.doi.org/10.12968/hmed.2005.66.7.18391.

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35

Lauten, Alexander, Henryk Dreger, Michael Laule, Karl Stangl, and Hans R. Figulla. "Caval Valve Implantation." Interventional Cardiology Clinics 7, no. 1 (January 2018): 57–63. http://dx.doi.org/10.1016/j.iccl.2017.08.008.

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36

Eisdorfer, Robert, and Paul Miskovitz. "Duodenal-caval fistula." Digestive Diseases and Sciences 36, no. 3 (March 1991): 379–80. http://dx.doi.org/10.1007/bf01318214.

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37

Smith, Brent A. "Vena Caval Filters." Emergency Medicine Clinics of North America 12, no. 3 (August 1994): 645–56. http://dx.doi.org/10.1016/s0733-8627(20)30406-5.

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38

Makovozov, O. O., I. M. Antonian, G. G. Khareba, R. V. Stetsyshyn, A. V. Maltsev, and P. V. Mozzhakov. "FACTORS OF PERIOPERATIVE MORTALITY IN PATIENTS WITH GROWING RENAL CELL CARCINOMA IN INFERIOR VENA CAVA LUMEN." International Medical Journal, no. 1 (February 14, 2021): 43–51. http://dx.doi.org/10.37436/2308-5274-2021-1-8.

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Difficult surgical cases of tumors of the inferior vena cava occur very often, because this intervention is characterized with technical difficulties and severe intraoperative complications. The most dangerous of these include massive bleeding, acute heart failure, and pulmonary embolism by tumor masses, which are the most common causes of perioperative mortality. Vena cava trombectomy is a special operation that can be accompanied by heavy bleeding at virtually any stage. The causes and frequency of mortality in 108 patients operated for renal cell carcinoma with growing to the inferior vena cava were retrospectively analyzed. Reliable factors for the prognosis of perioperative mortality in this pathology have been identified. Factors that characterize the tumor thrombus features, as well as parameters related to general condition of a patient, have been found to be of the greatest importance. The results of the study showed that the level of perioperative mortality in caval tumor thrombi is 8.3 % when using surgical methods without artificial circulation. The presented patient population contained a significant proportion of so−called "high" thrombi of III−IV levels, thrombi invading the wall of the inferior vena cava, as well as retrograde spread of intraluminal tumor. The main causes of death were acute heart failure, intraoperative bleeding, pulmonary embolism with tumor masses and acute renal failure. The prognostic value of perioperative mortality was demonstrated by the following thrombus factors: its "high" level, invasion of intraluminal tumor into the caval wall, signs of complete obstruction of caval blood flow. The mortality rate was objectively affected by severe heart failure, signs of pulmonary embolism before surgery. Key words: inferior vena cava, tumor thrombus, renal cell carcinoma, vena cava trombectomy, lethality.

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39

Tardu, Ali, Cuneyt Kayaalp, Sezai Yilmaz, Kerem Tolan, Veysel Ersan, Servet Karagul, Ismail Ertuğrul, and Serdar Kirmizi. "Reresection of Colorectal Liver Metastasis with Vena Cava Resection." Case Reports in Surgery 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/8173048.

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The best known treatment of the colorectal liver metastasis is the complete surgical excision with clean surgical margins. However, liver resections sometimes cannot appear technically feasible due to the high number of metastases in the liver, in cases of recurrent resections or invasion of the tumors to the major vascular structures or neighboring organs. Here, we presented a colorectal recurrent liver metastasis invading the retrohepatic vena cava, right adrenal gland, and right diaphragm. En masse resection of the tumor with caudate hepatectomy combined with vena cava resection and surrounding adrenal and diaphragm resections was accomplished. Caval reconstruction was done by a 5 cm in length cryopreserved vena cava homograft under isolated caval clamping. Postoperative period was uneventful and she was discharged on day 11. As a conclusion, combined liver and vena cava resection for a recurrent colorectal liver metastasis is a feasible procedure even with additional neighboring organ resections. Isolated vena cava occlusion with the preservation of the hepatic blood flow may decrease the risk of liver injury in case of previous chemotherapy for liver metastasis.

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Oulare, Fode Bangaly, Robert Karl Josef Clemens, Thomas Pfammatter, and Thomas Oleg Meier. "Duplication of the inferior vena cava with thrombotic complication: incidentally detected." BMJ Case Reports 13, no. 9 (September 2020): e232307. http://dx.doi.org/10.1136/bcr-2019-232307.

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Although the duplication of the inferior vena cava (IVCD) is usually clinically silent and often detected incidentally by image analysis, it may have important relevance during retroperitoneal surgery and endovenous procedures. Furthermore, IVCD may represent the primary provocating factor of unilateral iliofemoral vein thrombosis in patient with hypoplasia or thrombosis of one of the caval veins. This was the case in a 37-year-old man with acute painful swelling of the right leg. The patient was treated successfully by endovenous reconstruction of the occluded caval vein. A review of the pathophysiology, clinical manifestation and treatment of the IVCD is provided here.

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Music, Davor, Bozina Radevic, Goran Batricevic, and Aleksandar Filipovic. "Abdominal compartment syndrome caused by ruptured abdominal aortic aneurysm in vena cava." Vojnosanitetski pregled 63, no. 9 (2006): 843–46. http://dx.doi.org/10.2298/vsp0609843m.

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Background. Abdominal compartment syndrome (ACS) is a rapid increase in intra-abdominal pressure associated with multi-organs dysfunction. It is caused mostly by abdominal bleeding und massive volume compensation. Case report. We reported a 76-year-old patient admitted to the hospital with aortic abdominal aneurysm, 13.7 cm in diameter, ruptured in vena cava, which caused intraabdominal hypertension, the liver and kidney dysfunction, as well as circulation, respiration and metabolic disorders. Intraabdominal pressure was measured by bladder manometry. Central venous pressure and systemic arterial pressure were monitored continuously. Clinical signs were thrill and typical abdominal bruit. Aorto-caval fistula was diagnosed by the use of contrast computerized tomography. Caval endoaneurysmatic suture and aortobiiliac bypass with 18 ? 9 mm Dacron prothesis were performed. Haemodynamic changes were mostly corrected during the surgery. The complete correction of haemodynamics, liver, kidney, respiration and metabolic changes was established in the next few weeks. Conclusion. The ACS was caused by rupture of abdominal aortic aneurysm in vena cava followed by edema of the abdominal organs, retroperitoneum, abdominal wall and ascites. Caval endoaneurysmatic suture and aortobiiliac bypass with 18 ? 9 mm Dacron prothesis solved aortocaval fistula as well as all the organs and metabolic dysfunctions caused by ACS.

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Sheafor, D. H., T. M. Foti, S. N. Vaslef, and R. C. Nelson. "Fat in the inferior vena cava associated with caval injury." American Journal of Roentgenology 171, no. 1 (July 1998): 181–82. http://dx.doi.org/10.2214/ajr.171.1.9648784.

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Bogue, Conor O., Philip R. John, Bairbre L. Connolly, David J. Rea, and Joao G. Amaral. "Symptomatic caval penetration by a Celect inferior vena cava filter." Pediatric Radiology 39, no. 10 (July 9, 2009): 1110–13. http://dx.doi.org/10.1007/s00247-009-1340-4.

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44

Wood, C. E. "Sinoaortic denervation attenuates the reflex responses to hypotension in fetal sheep." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 256, no. 5 (May 1, 1989): R1103—R1110. http://dx.doi.org/10.1152/ajpregu.1989.256.5.r1103.

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Hypotension in fetal sheep stimulates reflex decreases in heart rate and increases in the secretion of several hormones, including adrenocorticotropin (ACTH), cortisol, vasopressin, and renin. However, little is known about the afferent limb(s) of the reflex(es) controlling these responses. Fetal sheep between 122 and 134 days gestation were prepared with chronic vascular catheters, intravascular balloon-tipped catheters, and amniotic fluid catheters. Seven fetal sheep were also subjected to sinoaortic denervation, and nine remained intact. After recovery from surgery for 2-5 days, fetuses were subjected to a 10-min period of hypotension produced by vena caval obstruction, produced by inflation of balloons in the superior and inferior venae cavae. Vena caval obstruction produced decreases in fetal heart rate and increases in fetal plasma ACTH, vasopressin, and renin activity, which were related to the degree of hypotension. Prior sinoaortic denervation attenuated all of these responses. It is concluded that afferent fibers in the carotid sinus and/or aortic depressor nerves mediate part of the heart rate, ACTH, vasopressin, and renin responses to vena caval obstruction in late-gestation fetal sheep.

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45

Coelho, Antônio Roberto de Barros, Álvaro Antônio Bandeira Ferraz, Renato Dornelas Câmara Neto, Ayrton Ponce de Souza, and Edmundo Machado Ferraz. "Subdiaphragmatic venous stasis and tissular hypoperfusion as sources of metabolic acidosis during passive portal-jugular and caval-jugular bypasses in dogs." Acta Cirurgica Brasileira 15, no. 2 (June 2000): 94–101. http://dx.doi.org/10.1590/s0102-86502000000200004.

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Subdiafragmatic venous decompression during anhepatic stage of canine orthotopic liver transplantation attenuates portal and caval blood stasis and minimize hipoperfusion and metabolic acidosis observed with occlusion of portal and caval veins. During two hours, six dogs submitted to portal-jugular and caval-jugular passive shunts, with maintenance of arterial hepatic flow, were evaluated for pH, carbon dioxide tension (PCO2), base deficit (BD) and oxygen tension (PO2) in portal, caval and systemic arterial blood, as well as for increments of BD (DBD) in portal and caval blood. With a confidence level of 95%, the results showed that: 1. There were not changes of pH anDBD in portal and systemic arterial blood in the majority of studied times; 2. There was metabolic acidosis in caval blood; 3. The negative increments of BD (DBD) were higher in caval blood than in splancnic venous blood at T10, T30 and T105; and, 4. Deoxigenation of portal and caval blood were detected. Acid-base metabolism and oxigenation monitoring of subdiaphramatic venous blood can constitute an effective way to evaluate experimental passive portal-jugular and caval-jugular bypass in dogs.

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46

Miller, Charles M. "Combined Hepatic and Vena Caval Resection With Autogenous Caval Graft Replacement." Archives of Surgery 126, no. 1 (January 1, 1991): 106. http://dx.doi.org/10.1001/archsurg.1991.01410250114020.

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47

Kayaalp, Cuneyt, and Sezai Yilmaz. "Caval Clamping During Total Hepatectomy with Caval Preservation in Liver Transplantation." Journal of Gastrointestinal Surgery 15, no. 8 (June 3, 2011): 1493–94. http://dx.doi.org/10.1007/s11605-011-1564-0.

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48

Sweet, W. D., R. H. Freeman, J. O. Davis, and R. C. Vari. "Ganglionic blockade in conscious dogs with chronic caval constriction." American Journal of Physiology-Heart and Circulatory Physiology 249, no. 5 (November 1, 1985): H1038—H1044. http://dx.doi.org/10.1152/ajpheart.1985.249.5.h1038.

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Chronic constriction of the thoracic inferior vena cava decreases venous return and cardiac output, increases the secretion of renin and aldosterone, and produces sodium retention with ascites and edema formation. The arterial pressure is maintained at normotensive levels in this caval model by an increase in total peripheral resistance. The objective of the present study was to compare renal and hemodynamic responses to ganglionic blockade in the conscious thoracic caval dog to responses obtained in another low-output model, the chronic sodium-deplete dog, and also to the responses obtained in the normal sodium-replete dog. The control base-line pressures averaged 103 +/- 2, 110 +/- 3, and 110 +/- 3 mmHg, respectively, in the sodium-replete, sodium-deplete, and thoracic caval dogs (P greater than 0.05). Ganglionic blockade in the conscious dog with caval constriction resulted in a sustained 20- to 30-mmHg fall in the arterial pressure; a sustained fall of 20 mmHg occurred in the sodium-deplete dogs. In contrast, ganglionic blockade failed to decrease the blood pressure at any time in the normal sodium-replete animals. Effective renal blood flow and creatinine clearance failed to demonstrate sustained changes after ganglionic blockade in any group of dogs; renal sodium excretion increased only in the normal sodium-replete dogs. These results suggest an enhanced contribution of the sympathetic nervous system to blood pressure maintenance in both the sodium-deplete and the caval dogs. Although the data fail to demonstrate an important contribution of the adrenergic system in the chronic sodium retention in these two experimental models, decreases in renal perfusion pressure may have blunted any potential natriuresis in these animals following ganglionic blockade.

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Ward, William H., David R. Donahue, Timothy A. Platz, and Christopher D. Scibelli. "Duodenal penetration of an inferior vena cava filter: case report and literature review." Vascular 21, no. 6 (May 13, 2013): 386–90. http://dx.doi.org/10.1177/1708538112472161.

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The insertion of inferior vena cava filters (IVCF) is a well-known therapy used in the prevention of pulmonary embolism (PE). The incidence of IVCF-related complications is low and complete caval penetration of a filter with adjacent organ injury has a reported incidence of 0–1%. We report the case of an 18-year-old male who sustained a spinal cord injury after a motor vehicle crash. The patient received a prophylactic IVCF and subsequently presented with right flank pain, postprandial nausea, and vomiting. His exam was benign and a computed tomography scan revealed extra-caval penetration of the filter with struts within the duodenal lumen and psoas muscle. The patient underwent an exploratory laparotomy with extraction of the filter, inferior vena cava venorrhaphy, and repair of the duodenal injury. This complication illustrates the potential morbidity of a common procedure and emphasizes the importance of investigating the IVCF as a possible source of abdominal pain.

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50

Kostreva, D. R., and S. P. Pontus. "Hepatic vein, hepatic parenchymal, and inferior vena caval mechanoreceptors with phrenic afferents." American Journal of Physiology-Gastrointestinal and Liver Physiology 265, no. 1 (July 1, 1993): G15—G20. http://dx.doi.org/10.1152/ajpgi.1993.265.1.g15.

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Dogs were anesthetized with pentobarbital sodium and placed on positive-pressure ventilation. The right phrenic nerve and/or its C5 branch were prepared for afferent recording. The hepatic veins, hepatic parenchyma, diaphragm, and inferior vena cava were studied for mechanoreceptors using light pressure and stroking as the stimuli. Mechanosensitive areas were found in the hepatic veins, hepatic parenchyma of the right medial lobe, and inferior vena cava. The hepatic vein and inferior vena caval receptors are located in the same 1- to 2-cm region as the sphincters that are found in these vessels. This study presents the first experimental evidence for the existence of hepatic vein receptors, hepatic parenchymal receptors, and inferior vena caval mechanoreceptors with phrenic afferents in the dog. These sensory areas of the circulation may be involved in the neural control of venous return as well as mediating changes in intrahepatic and portal venous blood pressure during normal respiration.

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