Del Campo C, Casey M T
Department of Surgery, Camp Hill Medical Centre, Halifax NS, Canada.
Tex Heart Inst J. 1993;20(4):288-92.
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.
上腔静脉或下腔静脉的严重狭窄或闭塞需要在特定患者群体中进行手术搭桥移植。当阻塞延伸至主要分支时，就需要使用分叉移植物。我们报告了2例接受手术治疗的患者，他们均在手术时接受了定制的带支架聚四氟乙烯分叉移植物。1例患者术后症状消失，另1例症状减轻。两个移植物均在1年内闭塞；然而，这一时间足以使侧支静脉循环形成，使两名患者均能对保守治疗产生良好反应。我们得出结论，带支架聚四氟乙烯分叉移植物对于特定患者可能是合适的，可作为侧支静脉形成前的过渡。开发顺应性更好的静脉移植物可能会带来更理想的结果。
