Reconstruction of the vena cava with the peritoneum

BACKGROUND: Reconstruction of the vena cava with an autologous vein require s extra incisions. Prosthetic material is associated with an increased risk of infection. We therefore created an animal model of vena cava reconstruc tion using the peritoneum. METHODS: A 2.5 x 2.5 cm piece of peritoneum was resected from 7 pigs weighi ng 30 to 40 kg. An oval window (long axis: 1.5 cm) was made in the infraren al vena cava. This was repaired with the peritoneal patch fixed in alcohol. RESULTS: In 2 animals sacrificed at 5 hours, there was no evidence of throm bosis, but there was fibrin clot on the patches. Two animals sacrificed on day 8 exhibited excellent patency of the vena cava. Complete endothelializa tion of the patch was noted at day 15. At 6 weeks, the vena cava was healed . No infections or other problems were noted. CONCLUSIONS: The peritoneum is an accessible and safe substitute for recons truction of the vena cava. Am J Surg. 2000;179:289-293. (C) 2000 by Excerpt a Medica, Inc.