• Vascular Specialist International
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• v.34 no.4
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• pp.117-120
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• 2018

The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.

• Journal of Chest Surgery
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• v.18 no.1
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• pp.128-139
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• 1985

Seven patients [six women and one man] with obstruction of hepatic portion of inferior vena cava was operated on, from May, 1969 to January, 1985. Of seven patients, six were undergone corrective operation for IVC obstruction and another one was not operated because of far advanced liver cirrhosis. The occlusions were found at or close to the level of diaphragm and they were membranous or diffuse with or without thrombi. Most of their symptoms were referable to either inferior vena caval or hepatic venous obstruction and onset of the symptoms was usually gradual, beginning between the age of their thirties and forties. Most of the patients showed marked elevation of peripheral venous pressure of lower extremity [29-40 cm H2O] preoperatively, which decreased significantly after corrective operation [17-30 cm H2O]. Venous catheterization for pressure study and venography were essential for confirming the diagnosis. Of six cases, in which corrective operations were done, Transatrial membranotomy with or without IVC dilatation were performed in five cases [case 1, 2, 3, 5, 6], using cardiopulmonary bypass and in another one case, bypass operation between IVC, distal to obstruction, and RA was done using Dacron tube graft under the thoracoabdominal incision. All survived and their conditions were improved.

• Journal of Chest Surgery
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• v.27 no.1
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• pp.52-56
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• 1994

This is case report of total anomalous pulmonary venous return with atrial septal defect which were corrected surgically by intracardiac procedure under total cardiopulmonary bypass.Two patients were supracardiac type,cardiac and mixed type was each one.The mixed type was three years old female patient.She was diagnosed as atrial septal defect with partial anomalous pulmonary venous return[right pulmonary vein drains into superior vena cava and right atrium] and corrected as usual.After operation,she underwent exertional dyspnea and frequent tachycardia.Chest x-ray film showed pulmonary congestion.Follow up cardiac cineangiogram revealed that left pulmonary vein also anomalously drained into left innominate vein through vertical vein.Through left thoracotomy,anastomosis was successfully carried between left atrium and vertical vein without cardiopulmonary bypass and there was no sign of pulmonary artery obstruction for two years follow up.The other three patient were corrected successfully without complication and got good result.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.834-838
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• 2003

Background: Deairing from the heart after open heart surgery(cardiopulmonary bypass) is a very important procedure. Artificial arteriovenous fistula was used to remove air, and the efficiency was evaluated by transesophageal echocardiography. Material and Method: Just before termination of cardiopulmonary bypass, a standard pressure transducer line is connected between the stopcocks of the connections in the arterial and venous circuits, creating a small controlled arteriovenous fistula between the arterial and venous cannulas. The degree of intracardiac air and air removal time were evaluated either by transesophageal echocardiography or direct vision of pressure transducer line. Result: By simple procedure, cardiopulmonary time was shortened and air clearing can be confirmed using echocardiography in a few minutes. Conclusion: Creation of arteriovenous fistula using small connecting line between aortic and venous cannula is a very simple and effective method of deairing and preventing of air embolism after open heart surgery.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.68-71
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• 2006

We operated on a 41-year-old man using venous bypass shunt for superior vena cava (SVC) syndrome caused by mediastinal fibrosis. The patient had substantially high venous pressure and high risk of postoperative neurologic deficits. The collateral veins were deemed to be interrupted during the surgical reconstruction of SVC. Treatment included resection of the obstructed SVC and innominate vein and reconstruction with an autologous pericardial tube graft. During the operation, venous drainage from upper body was maintained with an extraluminal bypass shunt. The shunt was effective at prompt relief of venous hypertension, eliminating the time constraints, and preventing the postoperative complications.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.534-537
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• 2010

A twenty six year old man was admitted to our clinic for bleeding from a venous ulcer of the left leg. His left femoral vein had been ligated for bleeding control after a traffic accident that happened when he was 5 years old. He had a varicose vein, stasis dermatitis, and a venous ulcer on his left leg. To shunt left femoral venous return to the right femoral vein, we did a crossover bypass with arteriovenous fistula using the right greater saphenous vein. To get good patency of the arteriovenous fistula, the bypass graft was closed 6 weeks after the initial operation. He maintained his left leg circumference relatively well for 6 months after the operation. We report the case of a patient who had a vein crossover bypass for a chronic femoral vein ligation.

• Journal of Chest Surgery
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• v.27 no.9
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• pp.801-803
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• 1994

We report a case of a 45-year-old woman with Budd-Chiari syndrome caused by the obstruction of the inferior vena cava just below the diaphragm. Transatrial dilatation or membranotomy was not possible due to the severe fibrotic obliteration of the inferior vena cava. Instead, cavoatrial bypass with a Dacron graft[20 mm-Vascutek] was performed under the median sternotomy and median abdominal incision.The postoperative course was uneventful and generalized symptoms were much improved. During the following period[6 month] the graft patency was maintained with no recurrence of symptoms.

• Journal of Chest Surgery
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• v.13 no.2
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• pp.110-117
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• 1980

This is a case report of total anomalous pulmonary venous drainage with Atrial septal defect, which was corrected surgically by intracardiac procedure under total cardiopulmonary bypass. This 9 years old girl, she complained mild cyanosis, exertional dyspnea, and frequent upper respiratory infection from 3 months age. The chest X-ray showed cardiomegaly and a "snow man appearance", she has systolic murmur with splitting of S2. The diagnosis was confirmed with right heart catheterization, the catheter was reached to right pulmonic vein passed through right atrium, right superior vena cava, innominate vein, left superior vena cava, and common venous trunk. On 28th, Dec. 1979, an anastomosis between common pulmonary venous trunk and left atrium, Pericardial patch closure of ASD, and ligation of left superior vena cava were performed with Extra-corporeal circulation. The postoperative course was uneventful and discharged with excellent general condition.Total Anomalous Pulmonary Venous Drainage with A.S.D. with A.S.D.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.7-10
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• 1995

Mixed Venous oxygenation saturation[SvO2 is a variable determined in part by the externally controlled factors and in part by the patient during CPB. I monitored the SvO2 and tested it as a parameter for the regulation of pump output and as a criteria for the need of inotropics after CPB. With the help of SvO2, I increased the pump flow especially during rewarming for more optimal oxygenation of cells. After CPB, the calculated cardiac index was used as an indicator for the need of inotropic support with greater accuracy and without any clinical problems. I conclude that the SvO2 is an easily checkable variable and a good indicator for optimal oxygenation at cell level, and can be used as an objective criteria for the need of postoperative inotropic support.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.319-327
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• 2013

Strategic planning is integral to any operation but complexity varies immensely and therefore the effort necessary to create the optimal plan. The previous three reports have discussed individual conduits and herein is an attempt to present approaches to common situations which the author favors. Although much has been learned over 45 years about use and subsequent behavior of venous and arterial grafts we continue to learn and, as a result, evolve new strategies or modify those now popular. Thus the reader must recognize that in spite of trying to be balanced and inclusive all surgeons have personal opinions and also prejudices which influence the approach taken and which may not be the optimal one for others or for the patient.