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

• Published in: Surgery today (Tokyo, Japan) Japan), 2024-02, Vol.54 (2), p.205-209
• Main Authors: Sakamoto, Katsunori, Iwamoto, Yukiharu, Ogawa, Kohei, Tamura, Kei, Ito, Chihiro, Iwata, Miku, Sakamoto, Akimasa, Shine, Mikiya, Nishi, Yusuke, Uraoka, Mio, Nagaoka, Tomoyuki, Honjo, Masahiko, Funamizu, Naotake, Takada, Yasutsugu
• Format: Article
• Language: English
• Subjects: Hepatectomy - methods; Hepatic Veins - anatomy & histology; Humans; Hydrodynamics; Liver - diagnostic imaging; Medicine; Medicine & Public Health; Short Communication; Surgery; Surgical Oncology; Vena Cava, Inferior - anatomy & histology
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-023-02733-6

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.