Venous anastomosis, open; caval-mesenteric
CPT4 code
Name of the Procedure:
Venous Anastomosis, Open; Caval-Mesenteric
Summary
Venous anastomosis, open; caval-mesenteric is a surgical procedure that involves connecting the inferior vena cava (a large vein carrying deoxygenated blood into the heart) to a mesenteric vein (a vein that drains blood from the intestines).
Purpose
The procedure aims to improve blood flow and drainage in cases where the inferior vena cava or mesenteric veins are damaged or blocked. This can alleviate symptoms related to poor blood circulation and prevent potential complications such as organ damage.
Indications
- Significant blockage or damage to the inferior vena cava or mesenteric veins.
- Symptoms like severe abdominal pain, swelling, and blood flow issues due to venous obstruction.
- Conditions such as thrombosis (blood clots) or tumors affecting these major veins.
Preparation
- Patients are typically instructed to fast for at least 8 hours prior to the procedure.
- Blood tests, imaging studies (such as CT scans or MRIs), and cardiovascular assessments are conducted to plan the surgery.
- Medication adjustments may be necessary, especially for blood thinners.
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made to access the surgical site.
- The surgeon identifies and isolates the inferior vena cava and mesenteric vein.
- The veins are carefully dissected and prepared for connection.
- The surgeon creates an anastomosis (connection) between the inferior vena cava and mesenteric vein using sutures or a specialized graft.
- Blood flow is restored, and the surgical site is closed.
Tools and equipment used include surgical scalpels, sutures, vascular clamps, and possibly graft materials. General anesthesia ensures the patient remains unconscious and pain-free during the procedure.
Duration
The procedure typically takes 3 to 5 hours to complete, depending on the complexity.
Setting
This procedure is performed in a hospital operating room.
Personnel
- A surgical team including a vascular or general surgeon
- An anesthesiologist
- Surgical nurses and technicians
Risks and Complications
- Infection at the incision site
- Blood clots
- Bleeding or hematoma formation
- Injury to surrounding organs or tissues
- Anesthesia-related complications
- Rarely, the anastomosis may fail, requiring additional surgery
Benefits
- Improved blood flow from the intestines and other abdominal organs
- Relief from symptoms like abdominal pain and swelling
- Prevention of complications such as bowel ischemia (lack of blood flow)
Recovery
- Patients may stay in the hospital for several days for monitoring and initial recovery.
- Post-operative care includes pain management, wound care, and gradual return to normal activities.
- Expect full recovery within 4 to 6 weeks, with follow-up appointments to monitor progress.
Alternatives
- Endovascular stenting to open blocked veins, which is less invasive but may not be suitable for all patients.
- Bypass surgery using different veins or synthetic grafts.
- Medical management with anticoagulants alone in less severe cases.
Each alternative has its own set of pros and cons, which should be discussed with the healthcare provider to determine the best approach.
Patient Experience
During the procedure, the patient is under general anesthesia and will not feel anything. Post-operatively, there may be pain at the incision site, which can be managed with medication. Patients might experience some discomfort and will need to take it easy for a few weeks while they recover.