VENOUS BLOOD INDICES AFTER CAVAPLICATION IN PATIENTS WITH THROMBOSIS OF THE VENA CAVA INFERIOR

Abstract

Summary. Despite reports of plication with inferior vena cava thrombosis, the venous hemodynamics before and after hardware cavaplication has been not evaluated.
 The aim of research. Estimate the changes of the venous blood flow indices after complication in patients with vena cava inferior thrombosis.
 Materials and methods. Quantitative assessment of venous blood flow was performed in 34 patients with inferior vena cava thrombosis before and after incomplete hardware cavaplication. Cavaplication was performed in 11 (32.4 %) patients with non-tumor and in 23 (67.6 %) patients with tumors of the vena cava inferior. For selecting the site of cavaplication, the infrarenal branch of the vena cava inferior directly below the renal veins was prevailed – in 29 (85.3 %) patients, the plication of vena cava inferior lower or higher hepatic veins in 4 (11.8 %) and 1 (2.9 %) patients were performed respectively.
 Results. Increases of following indices of central and regional hemodynamics after hardware cavaplication were observed, in particular, volume (by 56.5 %) and the linear rate of blood flow (by 40.4 %), minute volume of blood flow (by 16.2 %), cardiac index (by 8.8 %), systolic volume (by 6 %), end-systolic volume index (by 4.5 %), end-diastolic volume index (by 3.9 %) and ejection fraction (by 2.1 %). Instead, the pressure in the inferior vena cava (by 18.2 %) and stroke volume (by 8.9 %) decreased, which, however, was also considered as a positive result of thrombectomy from the vena cava inferior and hardware cavaplication.
 Conclusions. Within a year after inferior vena plication, indicators of central and peripheral hemodynamics were within the physiological norm and collateral pathways during radioisotope phleboscintigraphy weren`t determined. At the same time, the lumen of the vena cava inferior was completely restored, after 12-18 months, in all cases after plication.