Obstruction of the inferior vena cava following bicaval orthotopic heart transplantation: a case series.

ABSTRACT:

Background

Inferior vena cava (IVC) obstruction is a rare complication of orthotopic heart transplantation (OHT) and is unique to bicaval surgical technique. The clinical significance, diagnosis, complications, and management of post-operative IVC anastomotic obstruction have not been adequately described.

Case summary

Two patients with end-stage heart failure presented for bicaval OHT. Post-operative course was complicated with shock refractory to fluid resuscitation and inotropic/vasopressor support. Obstruction at the IVC-right atrial (RA) anastomosis was diagnosed on transoesophageal echocardiography (TOE), prompting emergent reoperation. In both cases, a large donor Eustachian valve was found to be restricting flow across the IVC-RA anastomosis. Resection of the valve r

SUBMITTER: Abudan A 

PROVIDER: S-EPMC7954254 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature