Department of Anesthesiology, Nippon Medical School, Tokyo, Japan.
Department of Anesthesiology, Nippon Medical School, Tokyo, Japan.
J Cardiothorac Vasc Anesth. 2021 Oct;35(10):3042-3044. doi: 10.1053/j.jvca.2020.11.063. Epub 2020 Dec 2.
Budd-Chiari syndrome (BCS) is a rare congestive hepatopathy arising from hepatic venous outflow obstruction. The clinical presentation of BCS varies depending on the presence of collateral veins. The authors report a rare case of infective endocarditis and chronic primary BCS in a 50-year-old man who underwent open cardiac surgery. Due to the presence of dilated collateral veins flowing directly into the inferior vena cava, cardiopulmonary bypass was established by arterial cannulation of the ascending aorta, with venous cannulation of the upper portion of the superior vena cava, as well as the dilated collateral vein. Mitral valve replacement and tricuspid valvuloplasty were performed uneventfully, and the patient then was admitted to the intensive care unit. Patients with primary BCS need to be evaluated rigorously preoperatively and intraoperatively for collateral flow to establish cardiopulmonary bypass.
布加综合征（BCS）是一种罕见的充血性肝疾病，由肝静脉流出道阻塞引起。BCS 的临床表现取决于侧支静脉的存在。作者报告了一例罕见的感染性心内膜炎和慢性原发性 BCS 病例，患者为 50 岁男性，曾接受过心脏直视手术。由于存在直接流入下腔静脉的扩张侧支静脉，升主动脉动脉插管，上腔静脉上部和扩张的侧支静脉静脉插管建立体外循环。二尖瓣置换和三尖瓣成形术顺利进行，然后患者被收入重症监护病房。原发性 BCS 患者需要在术前和术中对侧支血流进行严格评估，以建立体外循环。
