FEMORO-ARTERIAL BYPASS USING GOTT SHUNT IN LIVER-TRANSPLANTATION FOLLOWING SEVERE HEPATIC-TRAUMA

The heparinized-coated tube is widely used for arterial bypass, mainly in patients with aneurysms or trauma of the thoracic aorta. Its appli cation in venous bypass was less frequent. We report a 26-year-old wom an who sustained blunt abdominal injury which resulted in complete sev erance of the suprahepatic hepatic vein and multiple partial laceratio ns of the inferior vena cava. For hemostasis, total hepatectomy with i nterruption of the inferior vena cava was performed. During the anhepa tic phase, end-to-end portocaval anastomosis and a bypass shunt using 9 mm Gott tube from the right femoral vein to the right atrium were se t up for veno-venous bypass. Orthotopic liver transplantation was perf ormed later. Gott tube was placed for 18 hours with good venous return . We concluded that heparinized-coated tube is good for veno-venous by pass with the following advantages: 1) simple operative procedure, 2) enough flexibility to be kept out of the operative field, 3) no antico agulant is necessary, consequently less bleeding resulted.