Repair of the supradiaphragmatic inferior vena cava lacerated during redo open-heart surgery

Laceration of the inferior vena cava is among the more lethal of the vascular traumas. True mortality is higher if the lacerated segment is located in the upper part of the inferior vena cava, especially in the supradiaphragmatic portion. Knowledge of injuries of the inferior vena cava is mostly limited to those related to external trauma. The inferior vena cava may be lacerated during reoperation because of inappropriate dissection or uncontrolled traction. The authors used a diaphragmatic pericardial flap to repair the lacerated anterior wall of the supradiaphragmatic inferior vena cava and obtained good results in two cases requiring repeat open-heart surgery.