A case of acute superior vena caval obstruction after right sleeve pneumonectomy and partial resection of superior vena cava Use of temporary external jugular-femoral vein bypass

• Published in: The Journal of the Japanese Association for Chest Surgery Vol. 2; no. 2; pp. 71 - 78
• Main Authors: Miyake, Keijiro, Shimizu, Nobuyoshi, Teramoto, Shigeru
• Format: Journal Article
• Language: English; Japanese
• Published: The Japanese Association for Chest Surgery 15.06.1988
• Subjects: Acute superior vena caval obstruction; Lung cancer; Sleeve Pneumonectomy; Temporarly external jugiar-femoral veinbypass
• ISSN: 0917-4141; 1884-1724
• DOI: 10.2995/jacsurg1987.2.71

A-62-year old male with squamous cell carcinoma of the right lung underwent sleeve pneumonectomy and partial resection of the superior vena cava. On the day of operation and on the seventh postoperative day, the patient developed sudden hypotension accompanied by cyanosis, facial edema and unconsciousness. At the time of the first episode, conservative treatment was successful, but after the second, the patient's condition continued to deteriorate. Thrombectomy of the superior vena cava was performed with saphenous vein patch grafting. Prior to this operation, an external jugular-femoral vein bypass was placed with the use of a 16Fr. needle and hemodialysis system. During this procedure, the patient's condition improved immediately and r operation was performed safely. We feel that this method is useful in the treatment of acute and progressive superior vena caval obstruction. The surgical indications and intervention for advanced pulmonary or mediastinal carcinoma with involvement of the superior vena cava must be considered carefully.