Transthoracic Cavoatrial Shunt Treated Budd-Chiari Syndrome

Budd-Chiari Syndrom is often caused by obstruction of the inferior vena cava （IVC）.From April 1982 to April 1992,18 cases with obstruction of IVC,above hepatic vein,which were treated by transthoracic phrenohepatic IVC with atrium bypass in our hospital.The elec-tive criteria of this group are as follow:（1） The obstruction of the IVC above the opening of hepatic veins with patent hepatic veins.（2）The stenosis of the IVC at the level of diaphragm.The postoperation produce pleura effusion,and continued for quite long time,After 1988,the cut edges of diaphragm were sutured lockstich in 10 cases,then the effusion reduced obviously, and in hosnital were remarkably short（average 15.4 days）.Follow-up study from 9 months to 131 months（mean 53 months）.All patients returned to normal work showed that the results were excellent.Advantage of this operation is safe,without complication and death.The dissective limit is less.Operative time is short,and these patients recover quickly.The cavoatrial grafts are short（average 7.9cm）,and does not need anticoagulation,but their patency rate is high.