• P Zamboni, L Pisano, C Mari, R Galeotti, C Feo, and A Liboni.
• Institute of General Surgery and Vascular Laboratory, University of Ferrara, Italy.
• J Cardiovasc Surg. 1996 Dec 1;37(6):583-7.

AbstractMembranous obstruction of the inferior vena cava (MOIVC) is a rare, congenital or acquired, cause of Budd-Chiari syndrome leading to hepatocellular carcinoma in 20 to 40% of the patients. It has a very poor prognosis when treated medically and balloon angioplasty (PTA) represents, nowadays, the treatment of choice, having no mortality or significant morbidity with follow-up as long as 5 years; transatrial membranotomy, direct reconstruction of IVC and bypass surgery are alternative techniques when PTA is not feasible. One case of Budd-Chiari syndrome due to an incomplete membranous obstruction of the suprahepatic portion of the inferior vena cava is reported. A PTA was not feasible as it was not possible to pierce the membranous obstruction. A successful inferior vena cava-right atrium PTFE bypass, with a 3.5-year follow-up, was performed. This surgical approach is a valuable alternative to transatrial membranotomy and direct reconstruction of the IVC.

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