Title |
Good outcome following liver transplantation using pericardial-peritoneum window for hepato-atrial anastomosis to overcome advanced hepatic alveolar echinococcosis and secondary Budd-Chiari Syndrome - a case report
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Published in |
BMC Surgery, January 2017
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DOI | 10.1186/s12893-017-0205-2 |
Pubmed ID | |
Authors |
Konrad Kobryń, Rafał Paluszkiewicz, Krzysztof Dudek, Urszula Ołdakowska-Jedynak, Michał Korba, Joanna Raszeja-Wyszomirska, Piotr Remiszewski, Michał Grąt, Piotr Milkiewicz, Waldemar Patkowski, Marek Krawczyk |
Abstract |
This report presents a case of a 57- year old female with advanced Hepatic Alveolar Echinococcosis causing a secondary Budd-Chiari Syndrome due to infiltration of the suprahepatic inferior vena cava treated successfully by liver transplantation. A temporary veno-venous bypass was introduced, but a typical end to end cavo-caval anastomosis wasn't possible in this case. In order to access a disease free part of the inferior vena cava, an oval window of the diaphragm was excised, providing communication between the peritoneum and pericardium. A vascular clamp was placed onto the right atrium which allowed for an atrial-caval anastomosis. The remainder of hepatectomy was performed in a conventional manner. In the post-operative period and during the 18 month follow-up there were no complications. The patient remains in good general condition with optimal graft function. A hepato-atrial anastomosis with a pericardial-peritoneum window during liver transplantation is feasible and extends the curability potential for patients with advanced Hepatic Alveolar Echinococcosis considered for liver transplantation. |
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