ACTIVE VENOVENOUS BYPASS OF THE RETROHEPATIC VENA-CAVA UTILIZING 2 ATRIAL CANNULAE

Injuries to the hepatic veins and retrohepatic vena cava have a high m ortality due to uncontrolled hemorrhage. Successful repair may necessi tate interruption of flow through the retrohepatic vena cava. Active b ypass of the area is then needed to provide adequate venous return. Pu blished methods for active bypass require cannulation of axillary and femoral veins in addition to clamping of the vena cava above and below the liver, often with limited exposure and significant risk. This rep ort describes active bypass of the retrohepatic vena cava utilizing tw o right atrial cannulae, The simplicity of establishing the bypass tog ether with the excellent exposure allowed repair of a bullet wound of the vena cava in one patient and the orderly performance of a left tri segmentectomy for a huge hepatic tumor in a second patient.