Enteral patch repair of the vena caval defect: an experimental study

Abstract

Three adult mongrel dogs were aseptically prepared and celiotomy performed under general anesthesia. The inferior vena cava below the renal veins was dissected and a 5.0 cm segment of the vena cava was clamped with Satinsky vena cava clamp. A segment of the anterior wall, 7.0 x 14.0 mm, of the vena cava was resected and the defect was sutured to the serosa of the adjacent small bowel wall with 3-0 or 4-0 Dexon running sutures. The dogs were kept alive for 4 to 6 weeks postoperatively and the animals were reexplored and the vena cavogram was taken through a catheter in the common iliac vein using 60 per cent Urograffin. All three dogs were confirmed to have patent vena cava and the en-bloc segment of the vena cava and the small bowel was removed for the pathological specimen. The histological section of the specimen revealed a newly formed intimal layer covering the surface of the small bowel serosa patching the vena caval defect and this intimal layer was covered by a single layer of endothelial cells on the surface. With this result, the possibility of maintaining the full function of the vena cava following the repair of its defect with the enteral patch is confirmed. We do not have any clinical cases to be presented at this time, but this method may well be one of the applicable ways of repairing vena caval defects, although it may not be the best one.