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When accidental bleeding happens on the posterior wall of vena cava during the procedure of vena cava cannulation [Figure 1a], two pieces of thymus gland tissue around 2 cm × 1 cm were taken as the mattress tips, and these two pieces of tissue were put aside the bottom of vena cava, then use Prolene (Ethicon, Somerville, NJ, USA) to pass through the interspace under the posterior wall to make a mattress suture [Figure ​[Figure1b1b and ​andc].c]. Knot is tied with adequate tension to eliminate any obvious bleeding and to achieve complete hemostasis [Figure 1d]. In some cases, additional mattress sutures are needed to stop bleeding.    Figure 1  (a) Accidental bleeding on the posterior wall of vena cava during the procedure of vena cava cannulation; (b) Sutures passing through the interspace under the posterior wall with unilateral crossed thymus gland tissue; (c) Making the mattress suture; ...    This technique has now been tested effectively in three patients with the bleeding of posterior wall of vena cava without exposing the posterior wall. And more importantly, if this method failed to control the bleeding, the thymus gland tissues can be removed by cutting off the suture without doing any damage to the vessels. We believe the new technique described here is safe, effective, lower risk of infection (compared to artificial felt), and especially useful when the bleeding occurs after the cardiopulmonary bypass has been dismantled.

A Trick to Control the Bleeding in Cardiovascular Surgery