Superior Vena Cava Syndrome Publications (3876)


Superior Vena Cava Syndrome Publications

J Endourol Case Rep
J Endourol Case Rep 2016 1;2(1):240-242. Epub 2016 Dec 1.
Department of Surgery, Sanford School of Medicine, University of South Dakota , Rapid City, South Dakota.
World J Pediatr Congenit Heart Surg
World J Pediatr Congenit Heart Surg 2017 Jan 1:2150135116682455. Epub 2017 Jan 1.
1 Division of Congenital Heart Surgery, Hospital Privado Universitario de Córdoba, Córdoba, Argentina.

We report the case of an 11-year-old girl with heterotaxy syndrome, dextrocardia, and azygos continuation of an interrupted inferior vena cava who had developed pulmonary arteriovenous fistulas after a Kawashima procedure consisting of bilateral superior cavopulmonary anastomoses. She presented with profound cyanosis, fatigue, and failure to thrive. An operative procedure to direct hepatic vein effluent to the pulmonary circulation was performed with placement of an extracardiac conduit between the hepatic veins and the left pulmonary artery. Read More

Persistence of cyanosis led to investigation, which led to the discovery of an unintentionally excluded right hepatic vein. A percutaneous transhepatic catheter intervention was performed in which a vascular plug was implanted to occlude the "missed" right hepatic vein, redirecting the flow through intrahepatic venovenous channels to the conduit. Clinical condition and arterial oxygen saturation were substantially improved one year after the two-step hepatic vein inclusion procedure.

Pacing Clin Electrophysiol
Pacing Clin Electrophysiol 2017 Jan 5. Epub 2017 Jan 5.
Medtronic Bakken Research Center, Endepolsdomein 5, 6229 GW, Maastricht, the Netherlands.

Central Sleep Apnea Syndrome, correlated with the occurrence of heart failure, is characterized by periods of insufficient ventilation during sleep. This acute study in 15 patients aims to map the venous system and determine, if diaphragmatic movement can be achieved by phrenic nerve stimulation at various locations within the venous system.
Subjects underwent a scheduled catheter ablation procedure. Read More

During the procedural waiting time, one multi-electrode EP catheter was subsequently placed at the the superior and inferior vena cava and the junctions of the left jugular and left brachiocephalic vein and right jugular and right brachiocephalic vein, for phrenic nerve stimulation (1-2 seconds ON / 2-3 seconds OFF, 40 Hz, pulse width 210 μs). Diaphragmatic movement was assessed manually and by a breathing mask. During a follow-up assessment between 2-4 weeks post-procedure, occurrence of adverse events was assessed..
In all patients diaphragmatic movement was induced at one or more locations using a median threshold of at least 2 V and maximally 7.5 V (i.e, e 3.3 mA, 14.2 mA). The lowest median current to obtain diaphragmatic stimulation without discomfort was found for the right brachiocephalic vein (4.7 mA). In 12/15 patients diaphragmatic movement could be induced without any discomfort, but in 3 patients hick-ups occurred.
Diaphragmatic stimulation from the brachiocephalic and caval veins is feasible. Potential side effects should be eliminated by adapting the stimulation pattern. This information could be used to design a catheter, combining cardiac pacing with enhancing diaphragm movement during a sleep apnea episode. This article is protected by copyright. All rights reserved.

Int. J. Angiol.
Int J Angiol 2016 Dec 12;25(5):e51-e53. Epub 2014 May 12.
Ophthalmology Service, Dr. Negrín University Hospital of Gran Canaria, Las Palmas, Gran Canaria, Spain.

Creating an accessory source of pulsatile pulmonary blood flow in a patient with a bidirectional cavopulmonary anastomosis may have advantages and disadvantages. In relation to the latter, we report the complications seen in a cyanotic congenital heart disease patient who developed a superior vena cava syndrome plus severe swelling of his right hand that evolved satisfactorily after percutaneous and medical treatment. Read More

Eur J Vasc Endovasc Surg
Eur J Vasc Endovasc Surg 2016 Dec 19. Epub 2016 Dec 19.
Department of Vascular Surgery, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece; Department of Surgery and Cancer, Imperial College, London, UK.

The widespread use of central venous catheters, ports, pacemakers, and defibrillators has increased the incidence of benign superior vena cava syndrome (SVCS). This study aimed at reviewing the results of open and endovascular treatment of SVCS.
Medical literature databases were searched for relevant studies. Read More

Studies with more than five adult patients, reporting separate results for the SVC were included. Nine studies reported the results of endovascular treatment of SVCS including 136 patients followed up for a mean of 11-48 months. Causes of SVCS were central venous catheters and pacemakers (80.6%), mediastinal fibrosis (13.7%), and other (5.6%). Percutaneous transluminal angioplasty (PTA) and stenting was performed in 73.6%, PTA only in 17.3%, and thrombolysis, PTA, and stenting in 9%. Four studies reported the results of open repair of SVCS including 87 patients followed up between 30 months and 10.9 years. The causes were mediastinal fibrosis (58.4%), catheters and pacemakers (28.5%), and other (13%). Operations performed included a spiral saphenous interposition graft, other vein graft, PTFE graft, and human allograft. Thirteen patients required re-operations (15%) before discharge mainly for graft thrombosis.
In the endovascular group technical success was 95.6%. Thirty day mortality was 0%. Regression of symptoms was reported in 97.3%. Thirty-two patients (26.9%) underwent 58 secondary procedures. In the open group the 30 day mortality was 0%. Symptom regression was reported in 93.5%. Twenty-four patients (28.4%) underwent a total of 33 secondary procedures.
Endovascular is the first line treatment for SVCS caused by intravenous devices, whereas surgery is most often performed for mediastinal fibrosis. Both treatments show good results regarding regression of the symptoms and mid-term primary patency, with a significant incidence of secondary interventions.

Case Rep Emerg Med
Case Rep Emerg Med 2016 27;2016:7809281. Epub 2016 Nov 27.
University of Texas Dell Medical School, Emergency Medicine Residency, Austin, TX, USA.

Superior Mesenteric Artery (SMA) syndrome is a condition in which the duodenum becomes compressed between the SMA and the aorta, resulting in bowel obstruction which subsequently compresses surrounding structures. Pressure on the inferior vena cava (IVC) and aorta decreases cardiac output which compromises distal blood flow, resulting in abdominal compartment syndrome with ischemia and renal failure. A 15-year-old male with SMA syndrome presented with 12 hours of pain, a distended, rigid abdomen, mottled skin below the waist, and decreased motor and sensory function in the lower extremities. Read More

Exploratory laparotomy revealed ischemic small bowel and stomach with abdominal compartment syndrome. Despite decompression, the patient arrested from hyperkalemia following reperfusion.

Rom J Morphol Embryol
Rom J Morphol Embryol 2016 ;57(3):1075-1083
Department of Pathology, University of Medicine and Pharmacy of Craiova, Emergency County Hospital of Craiova, Romania;

T-cell÷histiocyte-rich B-cell lymphoma is a rare type of diffuse large B-cell lymphoma reported as involving primarily the thymus only by one paper in the English literature.
A four and a half years old boy was admitted, after a sudden onset in the middle of the night, with superior vena cava syndrome, resuscitated cardiac and respiratory arrest and severe coma with Glasgow Coma Scale rate of 3. In spite of intensive treatment, the patient repeated twice the cardiac arrest and died sixteen hours after admittance. Read More

The autopsy confirmed the existence of a huge mediastinal mass, revealed by the prior to death computed tomography examination, and the thorough histopatological established the diagnosis of T-cell÷histiocyte-rich large B-cell lymphoma of the thymus with renal spread.
The particularities of the presented case are the primary location of the lesion in the thymus, the age of the patient, very young, the lack of lymph nodes involvement and the rapid development of the disease until death without any possibility of therapeutic specific intervention.
The case is the second reported in the literature with primary involvement of the thymus by this rare variant of diffuse large B-cell lymphoma. The histopatological examination is the golden standard for the diagnosis. Any clinical symptom of unexplained fatigue and dyspnea in a child should raise the clinician's suspicion of a mediastinal mass involving the thymus.

Joint Bone Spine
Joint Bone Spine 2016 Dec 5. Epub 2016 Dec 5.
Service Radiologie centrale, Hôtel-Dieu, CHU Nantes, 44093 Nantes Cedex 01, France.

Nutcracker syndrome (NCS) is symptomatic unilateral renal venous hypertension due to compression of the left renal vein between the superior mesenteric artery and aorta (anterior NCS) or between the aorta and spine (posterior NCS). The left ovarian or spermatic vein empties into the left renal vein and is an additional site of venostasis in about half the cases of NCS. The presenting symptom of NCS in about half the cases is atypical left flank pain suggesting a disorder of the lower ribs or thoracolumbar spinal junction, particularly as the pain worsens with standing and increased lumbar lordosis. Read More

NCS may be suggested by any combination of the following manifestations: hematuria, which is often only microscopic; orthostatic proteinuria; varicocele and infertility; dyspareunia and other gynecological symptoms; varicose veins in the pelvis, buttocks, or upper thighs; orthostatic hypotension and fatigue; and abdominal pain. Narrowing of the left renal vein on imaging studies is required but far from sufficient to establish the diagnosis. Several converging clinical findings and a marked pressure gradient between the left renal vein and inferior vena cava must be present also. Urological procedures and vascular surgery are being superseded by endovascular stenting with or without simultaneous treatment of the acquired gonadal vein insufficiency by embolization.