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Explanting the migrated hepatic stent in the right atrium by modified vena caval inflow occlusion

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Abstract

Stenting of hepatic veins can be a long lasting solution for Budd–Chiari syndrome. These stents could very rarely migrate into the right atrium. During surgical retrieval, cardiopulmonary bypass (CPB) can be avoided if vena caval inflow occlusion (VCIO) is used. A hybrid alternative of VCIO by using a balloon to occlude the inferior vena cava was done to retrieve the stent thus avoiding CPB and total circulatory arrest.

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References

  1. Mukund A, Gamanagatti S. Imaging and interventions in Budd-Chiari syndrome. World J Radiol. 2011;3:69–177.

    Google Scholar 

  2. Raman J, Bellomo R, Shah P. Avoiding the pump in tricuspid valve endocarditis-vegetectomy under inflow occlusion. Ann Thorac Cardiovasc Surg. 2002;8:350–3.

    PubMed  Google Scholar 

  3. Raman J, Bhat D, Torabi A, Trohman R. Removal of retained pacing leads with vena caval inflow occlusion when cardiopulmonary bypass is contraindicated. Ann Thorac Surg. 2015;100:2379–80.

    Article  PubMed  Google Scholar 

  4. Singh J, Dhaliwal RS, Biswal S, Swami N. Inflow occlusion in the era of modern cardiac surgery. J Thorac Cardiovasc Surg. 2006;132:1246.

    Article  PubMed  Google Scholar 

  5. Torabi AJ, Dobrilovic N, Raman JS. Off-pump right atrial surgery: vena caval inflow occlusion in cardiac lesions. Asian Cardiovasc Thorac Ann. 2015;23:809–13.

    Article  PubMed  Google Scholar 

  6. Baraka AS, Aouad MT, Jalbout MI, Kaddoum RN, Khatib MF, Haroun-Bizri ST. End-tidal CO2 for prediction of cardiac output following weaning from cardiopulmonary bypass. J Extra Corpor Technol. 2004;36:255–7.

    PubMed  Google Scholar 

  7. Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth. 2009;103:i3–i13.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Lisie Hospital, Cochin, India

    Manoras Mathew Chengalath, Thomas Mathew & Jose Chacko Periappuram

  2. Department of Diagnostic and Interventional Radiology, PVS Memorial Hospital, Cochin, India

    Lijesh Kumar

  3. Department of Pediatric Anesthesiology, Lisie Hospital, Cochin, India

    Subramanian Chellappan

  4. Department of Pediatric Cardiology, Lisie Hospital, Cochin, India

    Edwin Francis

Authors
  1. Manoras Mathew Chengalath
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  2. Thomas Mathew
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  3. Lijesh Kumar
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  4. Jose Chacko Periappuram
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  5. Subramanian Chellappan
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  6. Edwin Francis
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Corresponding author

Correspondence to Manoras Mathew Chengalath.

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The authors declare that they have no conflicts of interest.

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Electronic supplementary material

Radiological image S1

Guide wires in the inferior vena cava and right hepatic vain. (GIF 292 kb)

High resolution image (TIFF 846 kb)

Radiological image S2

Dye in the inferior vena cava demonstrating the occluded intrahepatic segment. (GIF 213 kb)

High resolution image (TIFF 478 kb)

Radiological image S3

Balloon dilatation of the occluded segment. (GIF 359 kb)

High resolution image (TIFF 1041 kb)

Radiological image S4

Stent deployment in the occluded segment. (GIF 309 kb)

High resolution image (TIFF 841 kb)

Radiological image S5

Stent migration into the right atrial – inferior vena caval junction. (GIF 326 kb)

High resolution image (TIFF 938 kb)

Radiological image S6

Deployment of the second stent to pull back the migrated stent. (GIF 289 kb)

High resolution image (TIFF 856 kb)

Radiological image S7

Attempts to retrieve with the second stent and balloon. (GIF 310 kb)

High resolution image (TIFF 840 kb)

Radiological image S8

First stent at the RA- IVC junction. Second stent at stenotic segment of IVC (GIF 313 kb)

High resolution image (TIFF 902 kb)

ESM S9

(MOV 4306 kb)

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Chengalath, M.M., Mathew, T., Kumar, L. et al. Explanting the migrated hepatic stent in the right atrium by modified vena caval inflow occlusion. Indian J Thorac Cardiovasc Surg 35, 108–110 (2019). https://doi.org/10.1007/s12055-018-0718-z

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  • DOI: https://doi.org/10.1007/s12055-018-0718-z

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