Transcatheter stenting of superior vena cava to treat postoperative SVC syndrome in a child: a case report.

Balloon angioplasty of SVC Iatrogenic superior vena cava (SVC) obstruction Total anomalous pulmonary venous connection (TAPVC)

Journal

The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology
ISSN: 2090-911X
Titre abrégé: Egypt Heart J
Pays: Germany
ID NLM: 9106952

Informations de publication

Date de publication:
29 Aug 2024
Historique:
received: 16 06 2024
accepted: 22 08 2024
medline: 1 9 2024
pubmed: 1 9 2024
entrez: 29 8 2024
Statut: epublish

Résumé

Superior vena cava (SVC) obstruction leading to SVC syndrome is an uncommon but potential complication of cardiac surgeries that involve dissection and anastomosis around the great vein. We present a case of iatrogenic SVC obstruction that was initially treated with transcatheter balloon angioplasty, which provided temporary relief, and ultimately resolved by stenting the affected segment. The index case underwent total anomalous pulmonary venous connection (TAPVC) repair and presented 3 months after surgery with features of SVC obstruction. Initially, transcatheter balloon angioplasty was performed, providing relief from the obstruction; however, the condition recurred within one month. Finally, the patient was treated with percutaneous stenting of superior vena cava, through femoral venous route, using 8 mm × 30 mm balloon-expandable bare metal stent (Formula 418, Cook Medical, Bloomington, IN). Remarkable relief of obstruction was established with decrease in mean gradient across SVC-right atrium junction to 2 mm Hg (from 12 mm Hg before balloon angioplasty and 18 mm Hg before stenting). Percutaneous treatment for iatrogenic SVC obstruction developing after cardiac surgery appears to be effective. Close monitoring is required in the postoperative period for early diagnosis and timely intervention.

Sections du résumé

BACKGROUND BACKGROUND
Superior vena cava (SVC) obstruction leading to SVC syndrome is an uncommon but potential complication of cardiac surgeries that involve dissection and anastomosis around the great vein. We present a case of iatrogenic SVC obstruction that was initially treated with transcatheter balloon angioplasty, which provided temporary relief, and ultimately resolved by stenting the affected segment.
CASE PRESENTATION METHODS
The index case underwent total anomalous pulmonary venous connection (TAPVC) repair and presented 3 months after surgery with features of SVC obstruction. Initially, transcatheter balloon angioplasty was performed, providing relief from the obstruction; however, the condition recurred within one month. Finally, the patient was treated with percutaneous stenting of superior vena cava, through femoral venous route, using 8 mm × 30 mm balloon-expandable bare metal stent (Formula 418, Cook Medical, Bloomington, IN). Remarkable relief of obstruction was established with decrease in mean gradient across SVC-right atrium junction to 2 mm Hg (from 12 mm Hg before balloon angioplasty and 18 mm Hg before stenting).
CONCLUSION CONCLUSIONS
Percutaneous treatment for iatrogenic SVC obstruction developing after cardiac surgery appears to be effective. Close monitoring is required in the postoperative period for early diagnosis and timely intervention.

Identifiants

pubmed: 39210242
doi: 10.1186/s43044-024-00547-6
pii: 10.1186/s43044-024-00547-6
pmc: PMC11362416
doi:

Types de publication

Journal Article

Langues

eng

Pagination

115

Informations de copyright

© 2024. The Author(s).

Références

J Vasc Surg. 2008 Feb;47(2):372-80
pubmed: 18241760
Catheter Cardiovasc Interv. 2014 Jun 1;83(7):E272-6
pubmed: 22431347

Auteurs

Somrita Laha (S)

Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Premises No: 1489, Mukundapur Main Road, 124, Eastern Metropolitan Bypass, Mukundapur, Kolkata, West Bengal, 700099, India. somritalaha@gmail.com.

Debasree Gangopadhyay (D)

Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Premises No: 1489, Mukundapur Main Road, 124, Eastern Metropolitan Bypass, Mukundapur, Kolkata, West Bengal, 700099, India.

Mahua Roy (M)

Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Premises No: 1489, Mukundapur Main Road, 124, Eastern Metropolitan Bypass, Mukundapur, Kolkata, West Bengal, 700099, India.

Jayitri Mazumdar (J)

Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Premises No: 1489, Mukundapur Main Road, 124, Eastern Metropolitan Bypass, Mukundapur, Kolkata, West Bengal, 700099, India.

Mrinalendu Das (M)

Department of Cardiothoracic and Vascular Surgery, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India.

Patralekha Das (P)

Department of Cardiothoracic and Vascular Surgery, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India.

Classifications MeSH