Balloon cavoplasty in membranous obstruction of vena cava


  • Sunil Abhisek B. Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, Karnataka, India
  • Kumar B. Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, Karnataka, India



Balloon Cavoplasty, BCS, MOVC, PTBA


A hepatic venous outflow tract obstruction at any level is considered as Budd Chiari syndrome (BCS). Primary BCS is usually due to a congenital membrane causing the obstruction; referred to as membranous obstruction of vena Cava (MOVC). In the past MOVC was predominantly treated through surgery, percutaneous transluminal balloon angioplasty (PTBA) is an alternative and effective form of treatment. Case scenario of a 32-year-old gentleman presented himself with complaints of hematemesis for one year and hematochezia for three months. Hepatomegaly was noted. An ultrasonogram revealed a dilated IVC, till its hepatic portion, and also the Hepatic Veins. There was a fibrous membrane like structure of about 5 mm thickness that was obstructing the IVC flow. Patient was taken up for venogram for conformation of diagnosis and intervention. 6F NIH catheter was introduced from Femoral vein, an injection into the IVC showed contrast not flowing into right atrium and there was a membranous obstruction for the forward flow. A Brockenbrough’s trans-septal needle with Mullins Sheath was used to puncture the membrane and right atrium was entered. A 22 mm Inouye mitral valvuloplasty balloon (Single Balloon, Toray Medical, Tokyo) was taken and positioned at the membrane and inflated and deflated several times with incremental pressures till the waist of the balloon disappeared. Conclusion membranous obstruction of vena cava (MOVC) is a common cause of primary Budd Chiari syndrome. Percutaneous transluminal angioplasty using Inoue or mansfield balloon with or without stenting is a safe and effective treatment option.

Author Biographies

Sunil Abhisek B., Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, Karnataka, India

Senior Resident, Department of Cardiology

Kumar B., Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, Karnataka, India

Professor and Head of Department

Department of Cardiology


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How to Cite

Abhisek B., S., & B., K. (2017). Balloon cavoplasty in membranous obstruction of vena cava. International Journal of Research in Medical Sciences, 5(7), 3239–3242.



Case Reports