Volume 6, Issue 6, December 2018, Page: 173-177
Complicated Evolution of Superior Vena Cava Syndrome Post Cardiac Surgery
Adrian Fernando Narváez Muñoz, Department of Cardiovascular Surgery, Hospital de Especialidades Dr. Abel Gilbert Pontón, Guayaquil, Ecuador
Javier Aristides Rodriguez Herrera, Department of Cardiology, Hospital de Especialidades Dr. Abel Gilbert Pontón, Guayaquil, Ecuador
Daniela Albina Ibarra Vargas, Department of Cardiology, Hospital de Especialidades Dr. Abel Gilbert Pontón, Guayaquil, Ecuador
Carlos Ivan Soledispa Suarez, Department of Interventional Cardiology, Hospital de Especialidades Dr. Abel Gilbert Pontón, Guayaquil, Ecuador
Maxwell Ruben Velasco Salazar, Department of Cardiovascular Surgery, Hospital de Especialidades Dr. Abel Gilbert Pontón, Guayaquil, Ecuador
Carlos Alfredo Venegas Arteaga, Department of Cardiovascular Surgery, Hospital de Especialidades Dr. Abel Gilbert Pontón, Guayaquil, Ecuador
Received: Dec. 2, 2018;       Accepted: Dec. 17, 2018;       Published: Jan. 22, 2019
DOI: 10.11648/j.js.20180606.16      View  32      Downloads  26
Abstract
Introduction: Superior vena cava syndrome (SVCS) is the clinical manifestation of superior vena cava (SVC) obstruction, with a severe reduction in venous backflow to the right atrium. Symptoms classically include neck, facial and upper limb swelling, development of swollen collateral veins on the front of the chest wall, shortness of breath, coughing, headache, stridor and other neurological complaints, which may all be exacerbated by different postures. CASE REPORT: A 31-year-old man, with a sinus venosus atrial septal defect (SVASD) and partial anomalous pulmonary venous return (PAPVC), was undergone to surgery, in the postoperative course showed a superior vena cava syndrome (SVCS). A second surgery to solve this complication was performed nevertheless, some days after this intervention, the patient developed SVCS symptom’s once again. A new strategy with a large stent implantation in the superior vena cava had acceptable results. The patient kept asymptomatic during four months. Discussion: This syndrome is a rare complication after cardiac surgery; it is associated mostly with bicaval cannulation; various causes such as localized hematoma, swollen absorbable hemostat, and narrowing of the SVC by surgical sutures have been reported. There are no exact guidelines for the clinical management of SVCS. The treatments include long-term anticoagulation, thrombolysis, percutaneous transluminal balloon angioplasty, stent implantation, and open surgical reconstruction. CONCLUSION: This article highlights the importance of bear in mind the potential risk of SVCS during cardiac surgery with bicaval cannulation, whereby the proper precautions must be taken into account. Another outstanding fact of this case report shows the value of working with interventional cardiology department as a team to reach successful results in the benefit of the patients.
Keywords
Vena Cava Superior, Superior Vena Cava Syndrome, Angiography, Stent, Surgical, Tomography, Sinus Venosus Atrial Septal Defect
To cite this article
Adrian Fernando Narváez Muñoz, Javier Aristides Rodriguez Herrera, Daniela Albina Ibarra Vargas, Carlos Ivan Soledispa Suarez, Maxwell Ruben Velasco Salazar, Carlos Alfredo Venegas Arteaga, Complicated Evolution of Superior Vena Cava Syndrome Post Cardiac Surgery, Journal of Surgery. Vol. 6, No. 6, 2018, pp. 173-177. doi: 10.11648/j.js.20180606.16
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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