The American surgeon
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Three cases of hepatic vein and retrohepatic inferior vena caval injuries are reported, and the literature is reviewed. Our experience, coupled with a critical review of the literature reveals that successful vascular isolation of the relatively inaccessible retrohepatic vena cava and/or hepatic veins is the key to optimal surgical management of major injuries to these structures. ⋯ This incision not only gives optimal exposure to the injured site, but also allows easy atrial-caval cannulation. If cross-clamping of the abdominal aorta is necessary, it can be easily done via a median sternotomy.