Open fixation of a migrated aortic covered endograft for the management of a traumatic retrohepatic inferior vena cava injury with cardiopulmonary bypass

We report a case of a gunshot wound retrohepatic inferior vena cava injury treated with an aortic endograft that subsequently migrated into the right atrium, which was successfully treated with right atrial opening and stent fixation under cardiopulmonary bypass. This case highlights the potential utility of off-label aortic endografts in managing complex retrohepatic inferior vena cava injuries as a highly effective alternative to the historically morbid atriocaval Schrock shunt. The high location of the injury, near the right atrium, underscores the technical difficulty and need for multidisciplinary collaboration to achieve a successful outcome.