• Masashi Ishikawa and Atsuhiro Sakamoto.
• Department of Anesthesiology, Nippon Medical School, Tokyo, Japan. Electronic address: masashi-i@nms.ac.jp.
• J. Cardiothorac. Vasc. Anesth. 2021 Oct 1; 35 (10): 3042-3044.

AbstractBudd-Chiari syndrome (BCS) is a rare congestive hepatopathy arising from hepatic venous outflow obstruction. The clinical presentation of BCS varies depending on the presence of collateral veins. The authors report a rare case of infective endocarditis and chronic primary BCS in a 50-year-old man who underwent open cardiac surgery. Due to the presence of dilated collateral veins flowing directly into the inferior vena cava, cardiopulmonary bypass was established by arterial cannulation of the ascending aorta, with venous cannulation of the upper portion of the superior vena cava, as well as the dilated collateral vein. Mitral valve replacement and tricuspid valvuloplasty were performed uneventfully, and the patient then was admitted to the intensive care unit. Patients with primary BCS need to be evaluated rigorously preoperatively and intraoperatively for collateral flow to establish cardiopulmonary bypass.Copyright © 2020 Elsevier Inc. All rights reserved.

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