Vena cava bypass with stented polytetrafluoroethylene bifurcated grafts. A report of 2 cases

Severe stenosis or occlusion of either the superior or the inferior vena cava requires surgical bypass grafting in a selected group of patients. When the obstruction extends into the major tributaries, a bifurcated graft becomes necessary. We present the cases of 2 surgically treated patients, each of whom received a stented polytetrafluoroethylene bifurcated graft constructed at the time of the operation. Symptoms disappeared post-operatively in 1 patient and abated in the other. Both grafts became occluded within 1 year; however, that was sufficient time for collateral venous circulation to develop, enabling both patients to respond well to conservative therapy. We conclude that stented polytetrafluoroethylene bifurcated grafts may be suitable for selected patients as a bridge until collateral veins can form. The development of more compliant venous grafts may provide even more favorable results.