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September 1990

Transatrial Interruption of the Inferior Vena Cava

Author Affiliations

From the Divisions of Vascular Surgery (Dr Cutler) and Cardiac Surgery (Dr Salm), University of Massachusetts Medical Center, Worcester, and the Department of Surgery, University of Michigan, Taubman Health Care Center, Ann Arbor (Dr Greenfield).

Arch Surg. 1990;125(9):1222-1223. doi:10.1001/archsurg.1990.01410210148026

• Transatrial placement of a Greenfield filter at the time of cardiac surgery was performed on three patients with recent femoral venous thrombosis and unstable angina, and at the time of pulmonary embolectomy on four others. The filter carrier was passed through the right atrial cannulation site under fluoroscopic guidance into the inferior vena cava. A preliminary vena-cavogram was performed through the carrier or a previously placed angiographic catheter. Two complications were encountered: the first was misplacement of a filter in the right renal vein before routine venacavography was employed; the second was caudal displacement of a filter by a right atrial venous drainage cannula that projected into the inferior vena cava. The latter complication can be prevented by the use of a right atrial "sump" drain that does not protrude into the inferior vena cava.

(Arch Surg. 1990;125:1222-1223)