Veno-Venous Bypass

Veno-Venous Bypass

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A technique employed to mitigate the effects of obstructing the vena cava.

Anesthetic implications

History:

Occlusion of the inferior vena cava at the level of the diaphragm reduces venous return to the right atrium by up to 60%. Historically this technique provided an alternative route of venous return during liver transplant. Advances in surgical technique particularly, piggyback implantation with partial occlusion of the ICV, have reduced the dependence on VVB at many centers in the United States.

Technique:

The bypass circuit consists of a heparin bonded tubing, a centrifugal pump, and a heat exchanger.

Related surgical procedures

Liver transplant, Liver resection, nephrectomy for RCC with extension into the IVC, other surgery requiring extended duration of caval obstruction