Impact of the inferior vena cava morphology on fluid dynamics of the hepatic veins.

We reported previously that a large vertical interval between the hepatic segment of the inferior vena cava (IVC) and right atrium (RA), referred to as the IVC-RA gap, was associated with more intraoperative bleeding during hemi-hepatectomy. We conducted a computational fluid dynamics (CFD) study to clarify the impact of fluid dynamics resulting from morphologic variations around the liver. The subjects were 10 patients/donors with a large IVC-RA gap and 10 patients/donors with a small IVC-RA gap. Three-dimensional reconstructions of the IVC and hepatic vessels were created from CT images for the CFD study. Median pressure in the middle hepatic vein was significantly higher in the large-gap group than in the small-gap group (P = 0.008). Differences in hepatic vein pressure caused by morphologic variation in the IVC might be one of the mechanisms of intraoperative bleeding from the hepatic veins.

Unification venoplasty during two versus one venous reconstruction: Computational fluid dynamics study.

Two versus 1 venous reconstruction is sometimes required for Hepato-Biliary-Pancreatic and Transplantation surgery. V-shape venoplasty is considered to be useful knack of unification method during 2 versus 1 venous reconstruction in clinical practice. The usefulness of V-shape unification venoplasty was proven by the present computational fluid dynamics study.