Open angioplasty of Budd-Chiari syndrome with self-blood recovery and transfusion after heparinization: an analysis of 57 cases     LIU Jian,HUANG Ji-xiu,LIN Xiao-bin,et al. Department of Cardiovascular Surgery, the People’s Hospital of Jianyang, Jianyang  641400, China
Corresponding author：LIU Jian, E-mail:liujiun688@sina.com
Abstract    Objective    To summarize the experience of treatment on open angioplasty of Budd-Chiari syndrome (BCS) in heparinization and no cardiopulmonary bypass (N-CPB). Methods    The clinical data of 57 cases of  BCS performed open angioplasty in heparinization and N-CPB from November 1997 to May 2011 at the People’s Hospital of Jianyang were analyzed retrospectively. The operation includes following key points: heparinization of blood but N-CPB, blocking the distal side of the obstruction in inferior vena cava by a Foley’s catheter, blooding controlled, blood retrieved by negative pressure and the blood transfused through the cannulas in right atrium. Results    The inferior vena cava pressure dropped obviously (from 17.5-30.3 mmHg to 9-13 mmHg) with significant difference. Self-blood volume transfused 600-40 000 mL in per case. The self-blood volume transfused was over 10 000 mL in 8 cases. All cases didn’t transfuse stocking blood in operating period except for 1 case. There were not serious complications occurred including upper gastrointestinal haemorrhage, hepatic coma, acute renal failure and pulmonary artery embolism, ect. One case(1.82％) died in 24 hours after operation due to bleeding of inferior vena cava．Conclusion    Compared with the way in CPB and deep hypothermic circulatory arrest, open angioplasty with self-blood recovery and transfusion after heparinization may simplify processes on open angioplasty of BCS, reduce operating injury and ensure the effect of operation.