Concomitant prophylactic inferior vena caval clipping.

Fatal pulmonary embolism is a common complication of any major surgery, especially in high risk patients. Experimental work in animals showed definite impairment of myocardial function after inferior vena caval ligation, but no changes after clipping. During the last four years, we have used concomitant vena caval clipping as a prophylactic measure in major abdominal vascular procedures. No added mortality or morbidity has occurred because of clipping per se and no deaths were due to pulmonary embolism. We recommend concomitant prophylactic clipping as an adjunctive procedure for all laparotomy patients who are prone to pulmonary embolism.