Reduction of the Postoperative Thrombogenic Risk in Reconstruction on the Obstructed Superior Caval Vein with Autovenous in situ Flap

The experimental and anatomical studies show the possibilities to use the autovenous in situ flap from the AV, RSV and BCVs in reconstruction of the obstructed SCV. The authors discuss the possibilities to reduce the postoperative thrombogenic risk in reconstruction on the obstructed SCV with the next reconstructive surgical procedures with autovenous in situ flap: – The closure of the lateral partial defect of the wall of the SCV with the in situ flap from the AV. – The closure of the lateral partial defects of the wall of the SCV, with the in situ RSV and RBCV flap and medial partial defects – with LBCV flap. – The complete replacement of the SCV with LBCV. Concerning the reduction of the postoperative thrombogenic risk, the reconstruction of the obstructed SCV with the autovenous in situ flaps has several advantages: – The techniques keep the proper vascularization of the autovenous in situ flaps, and reduce the ischemia in the flap, which leads to the best preservation of the endothelial cells. – The techniques permit the postoperative dilatation of the implanted vein; the use of the additional oblique incision of the vein leads to the increase of the diameter of the anastomotic ring. In the area of the anastomosis, the veins were sutured with separate single sutures; the advantage of the separate single sutures in comparison with the continuous suture is that the separate single sutures do not limit the postoperative dilatation of the LBCV in the area of the anastomotic ring.