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Immediate and Long-term Hemodynamic Effects

Stephen M. Korwin, MD; Allan D. Callow, MD; David Rosenthal, MD; C. Bruce Ledig, MD; Ralph A. Deterling, Jr, MD; Thomas F. O'Donnell, Jr, MD

Arch Surg. 1979;114(9):1037-1040.

Abstract
• Two hundred patients were evaluated retrospectively to determine the clinical effects of prophylactic inferior vena cava (IVC) interruption in association with aortic reconstruction. No pulmonary embolism occurred in the group with IVC interruption, but embolisms did occur in seven of 68 patients who had aortic reconstruction performed without IVC interruption. In two patients, the pulmonary embolism was fatal. Postoperative incidence of deep vein thrombosis was 9% in both groups. Clinical and hemodynamic effects of prophylactic IVC interruption were studied in 20 additional patients. Venous hemodynamics (maximum venous outflow, inferior vena cava pressure, and ambulatory venous pressure) showed no change following interruption in 19/20. Sixteen patients from the original group of patients with prophylactic interruption were studied hemodynamically. No pulmonary embolism was clinically evident. One new case of deep vein thrombosis was seen. Again, venous hemodynamics showed no change as a result of IVC interruption. Prophylactic IVC interruption is a safe means of decreasing the incidence of pulmonary embolism without increasing venous-related morbidity.

(Arch Surg 114:1037-1040, 1979)

Author Affiliations
From the Department of Surgery, Tufts-New England Medical Center, Boston.

Footnotes
Accepted for publication April 17, 1979.

Read before the fifth annual meeting of the New England Society for Vascular Surgery, Dixville Notch, NH, Sept 28, 1978.

Reprint requests to Department of Surgery, Tufts-New England Medical Center, 171 Harrison Ave, Boston, MA 02111 (Dr Callow).

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