Cossio and Perianes1 of Buenos Aires suggested in 1948 two types of surgical intervention for the relief of the overburdened pulmonary venous system in cardiac decompensation. One type consisted of a procedure in which the blood from the pulmonary venous system was shunted to some sector of the systemic circulation by an anastomosis of a large pulmonary vein with the axillary vein, the splenic vein, or the azygos vein. The second type had for its objective the reduction of the right ventricular output either by means of a tricuspid valvulotomy resulting in tricuspid regurgitation or by means of ligation of the inferior vena cava.
Cossio and Perianes performed vein anastomoses in dogs and also valvulotomies utilizing the jugular vein approach. When valvulotomy was successful, the systolic pressure in the right ventricle fell to approximately 50% of its initial pressure, while it rose only 1 mm. Hg in the right
LIGATION OF THE INFERIOR VENA CAVA IN CARDIAC DECOMPENSATION. JAMA. 1952;149(11):1021. doi:https://doi.org/10.1001/jama.1952.02930280043012
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