Portalvein reconstruction with a cadaveric descending thoracic aortic homograft

Ann C. Gaffey, MD, MS; Jason Zhang, MD; Major K. Lee, MD, PhD; Robert Roses, MD; Benjamin M. Jackson, MD; Jon G. Quatromoni, MD

Journal of Vascular Surgery Cases and Innovative Techniques (Jun 2022)

Portalvein reconstruction with a cadaveric descending thoracic aortic homograft

Ann C. Gaffey, MD, MS,
Jason Zhang, MD,
Major K. Lee, MD, PhD,
Robert Roses, MD,
Benjamin M. Jackson, MD,
Jon G. Quatromoni, MD

Affiliations

Ann C. Gaffey, MD, MS: Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Diego, La Jolla, CA; Correspondence: Ann C. Gaffey, MD, MS, Division Vascular and Endovascular Surgery, Department of Surgery, University of California, San Diego, 9434 Medical Center Dr, Mail Code 7403, La Jolla, CA 92037
Jason Zhang, MD: Division of Vascular Surgery and Endovascular Therapy, University of Pennsylvania Health System, Philadelphia, PA
Major K. Lee, MD, PhD: Division of Gastrointestinal Surgery, University of Pennsylvania Health System, Philadelphia, PA
Robert Roses, MD: Division of Endocrine and Oncologic Surgery, University of Pennsylvania Health System, Philadelphia, PA
Benjamin M. Jackson, MD: Division of Endocrine and Oncologic Surgery, University of Pennsylvania Health System, Philadelphia, PA
Jon G. Quatromoni, MD: Department of Vascular Surgery, Cleveland Clinic, Cleveland, OH

Journal volume & issue: Vol. 8, no. 2
pp. 294 – 297

Abstract

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Improvements in chemoradiotherapy have rendered complex pancreatic cancers involving the portal vein (PV) amenable to resection. PV reconstruction (PVR) is an essential component. Various conduits have been proposed; however, the optimal choice remains unknown. Fourteen patients underwent PVR with a cadaveric descending thoracic aortic homograft from 2014 to 2020. The primary diagnosis was pancreatic cancer. The splenic vein was ligated in seven patients (50%). The 30-day and 3-, 12-, and 24-month primary patency rates were 100%, 86%, 76%, and 76%, respectively. We found a cadaveric descending thoracic aortic homograft is an excellent conduit for PVR, given the optimal size, rapidly availability, favorable risk profile, and absence of harvest site complications.

Published in Journal of Vascular Surgery Cases and Innovative Techniques

ISSN: 2468-4287 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/journal-of-vascular-surgery-cases-innovations-and-techniques

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Abstract

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