Hybrid Approach for the Treatment of Superior Vena Cava Syndrome Induced by Pacemaker

• Published in: The Annals of thoracic surgery Vol. 104; no. 2; pp. e131 - e132
• Main Authors: Maseda Uriza, Ramón, Jurado-Román, Alfonso, Jimenez Díaz, Javier, Piqueras Flores, Jesús, Higuera Sobrino, Felipe, Oliva De Anquín, Enrique
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.08.2017
• Subjects: Aged; Atrioventricular Block - therapy; Catheterization, Peripheral - methods; Device Removal - methods; Femoral Vein; Humans; Male; Pacemaker, Artificial - adverse effects; Phlebography; Superior Vena Cava Syndrome - diagnosis; Superior Vena Cava Syndrome - etiology; Superior Vena Cava Syndrome - surgery; Thoracotomy - methods; Tomography, X-Ray Computed; Ultrasonography, Doppler; Vena Cava, Superior - diagnostic imaging
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2017.02.063

Pacemaker-induced superior vena cava syndrome (SVCS) is a rare but incapacitating adverse event that can occur years after implantation. Inasmuch as it is a rare disease, there is no consensus about its treatment. The most widely used option is balloon angioplasty and venous stent implantation, with preservation of the lead or previous extraction and subsequent reimplantation after the procedure, which is associated with new episodes of thrombosis. The epicardial implantation reduces the risk of thrombosis. We report a case of pacemaker-induced SVCS for which we used a hybrid approach for epicardial lead implantation and electrode extraction, balloon angioplasty, and stent implantation.