Technical options in reconstruction of large mediastinal veins.
Twelve patients who underwent graft replacement of the large mediastinal veins were reviewed. A preoperative superior vena caval (SVC) syndrome was present in seven patients. The most frequent diagnosis was a primary thoracic malignant neoplasm (10 patients). Reconstruction was performed with a pericardial tube in four patients, venae saphena magna in three patients, umbilical vein in three patients, and Dacron grafts in two patients. A temporary bypass was used in three patients. All the patients survived the operation. Eight patients died within 15 months of the surgery. Four patients are long-term survivors without signs of an SVC syndrome. Based on our experience and a review of the literature, we recommend the use of two autogenous vein grafts or a ringed polytetrafluoroethylene graft with a diameter of about one half that of the normal SVC to replace the large mediastinal veins.
Larsson
S
S
Department of Thoracic and Cardiovascular Surgery, Sahlgren's Hospital, University of Gothenburg, Göteborg, Sweden.
Lepore
V
V
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008223:Lymphoma / Q000601:surgery; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D012189:Retrospective Studies; D013479:Superior Vena Cava Syndrome / Q000209:etiology / Q000601:surgery*; D013899:Thoracic Neoplasms / Q000601:surgery*; D013945:Thymoma / Q000601:surgery; D013953:Thymus Neoplasms / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods*