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Iatrogenic Inferior Vena Cava Resection Requiring Reconstruction
Hossam Alslaim1, Jane Chung1, Edward Kruse2
1Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA.
Vascular and Endovascular Surgery
|April 28, 2021
Summary
This case report details the successful reconstruction of an inferior vena cava (IVC) segment using bovine pericardium after inadvertent resection during surgery. The graft allowed for successful IVC reconstruction, managing severe edema and demonstrating the material's utility in infected fields.
Area of Science:
- Vascular Surgery
- Biomaterials Science
- Surgical Complications
Background:
- A 48-year-old female underwent a planned right nephrectomy for xanthogranulomatous pyelonephritis.
- An 8 cm segment of the infrarenal inferior vena cava (IVC) was inadvertently resected during the procedure.
- Ligation of the IVC was not tolerated due to severe lower extremity edema, necessitating reconstruction.
Observation:
- The patient required reconstruction of the resected IVC segment.
- A bovine pericardium conduit was utilized as an interposition graft for IVC reconstruction.
- The surgical field was considered infected due to the underlying pyelonephritis.
Findings:
- Successful reconstruction of the infrarenal IVC segment was achieved using a bovine pericardium graft.
- The patient's postoperative course was complicated by a pulmonary embolism, which required percutaneous intervention.
- The bovine pericardium graft facilitated IVC reconstruction in a potentially infected surgical field.
Implications:
- Bovine pericardium serves as a viable option for inferior vena cava reconstruction, even in infected surgical fields.
- This case highlights a potential solution for managing iatrogenic IVC injuries during abdominal surgery.
- Further research into the long-term efficacy and safety of bovine pericardium for IVC reconstruction is warranted.
