Reconstruction of the vena cava with the peritoneum: the effect of temporary distal arteriovenous fistula on patency (an experimental study)

Abstract

Objective: To determine the effect of increasing inferior vena cava blood flow by means of distal arteriovenous fistula on the patency of a peritoneal tube graft.

Materials and methods: In 16 mongrel dogs, a 3-4 cm long circular defect was created at the infrarenal inferior vena cava. The defect was interposed with peritoneal tube graft. A temporary distal femoro-femoral arteriovenous fistula was also constructed in 8 dogs just after the caval interposition. Graft patency was evaluated by Doppler ultrasonography and angiography. Histological evaluation was also performed.

Results: Seven dogs in each group survived. All control grafts occluded within the first week, compared to no occlusions in fistula group (Fisher's exact test, p<0.005). However one 'fistula' dog with a still patent graft was sacrificed on the 18th day due to ultrasonographically occluded arteriovenous fistula.

Conclusion: In dogs, the peritoneum may be used as graft material for reconstruction of the inferior vena cava, provided a distal arteriovenous fistula is constructed.