Surgical Patch Treatment of SVC Syndrome Caused by Transvenous Pacemaker Lead.
10.4326/jjcvs.23.133
- VernacularTitle:ペースメーカーリードによる上大静脈症候群に上大静脈パッチ拡大術を施行した１例
- Author:
Hironori Izutani
;
Satoru Kuki
;
Ryuichi Matsumura
;
Akihiro Okuda
- Publication Type:Journal Article
- Keywords:
Locking Stylet
- From:Japanese Journal of Cardiovascular Surgery
1994;23(2):133-137
- CountryJapan
- Language:Japanese
-
Abstract:
A 56-year-old male had complained of serious facial edema 2 years after transvenous pacemaker implantation. Venography at admission showed complete occlusion of the left innominate vein and severe stenosis of the SVC. A 20mmHg pressure gradient was recognized between bilateral internal jugular veins and SVC. Various conservative therapeutic approaches had been ineffective, then surgical treatment was recommended. A median sternotomy was made, removing the pacing lead by a Locking Stylet easily and safely. The stenotic section was dilated, resecting the fibrous tissue in the thickened venous wall, and enlarged with a shaped pericardial patch. Symptoms diminished postoperatively. Histological findings revealed phlebosclerosis of the stenotic venous wall. This type of surgical approach is effective for lesions with irreversible occlusion or severe stenosis causing SVC syndrome and which do not respond to conservative therapy.
