title: Reconstruction of the superior vena cava by biologic conduit: assessment of long-term patency by magnetic resonance imaging.
abstract: BACKGROUND
  To assess the long-term patency of the biologic prosthetic conduit used for reconstruction of the superior vena cava (SVC) by magnetic resonance imaging (MRI).
  
  
  METHODS
  Patients undergoing oncologic resection and reconstruction of the SVC by a bovine pericardial prosthesis (January 2003 to April 2010) have been studied after 1 year (if surviving) by MRI for the assessment of the conduit long-term patency. Results were compared with those of a control group of patients with normal SVC. Blood flow and area of lumen section at 3 different levels (proximal, middle, distal) were analyzed.
  
  
  RESULTS
  Sixteen consecutive patients surviving after 1 year from surgery out of 17 (9 lung cancer, 8 mediastinal malignancy) undergoing SVC reconstruction were included. One patient died postoperatively and was not included. Sixteen patients with similar demographic characteristics were studied in the control group. Mean blood flow was 18.4±3.5 mL/sec (range 14.3 to 25.7) in patients with reconstructed SVC and 20.8±4.1 mL/sec (range 15.3 to 27.7) in the control group. Mean area of the conduit lumen section was 2.2±0.6 cm2 (range 1.6 to 3.6) at proximal level, 2.9±1.3 cm2 at middle level (range 1.3 to 5.7), and 2.1±0.9 cm2 (range 0.5 to 4) at distal level in the reconstructed group, and 2.6±0.7 cm2 (range 1.8 to 4.2), 2.7±0.7 cm2 (range 1.9 to 4.3), and 2.4±0.3 cm2 (range 1.8 to 3.1), respectively, at proximal, middle, and distal levels in the control group. Differences between the 2 groups were not significant (p>0.05).
  
  
  CONCLUSIONS
  The MRI assessment in terms of blood flow and area of lumen section at 3 different levels confirms that bovine pericardial conduit used for SVC replacement shows an optimal patency over the long term.
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy. adandrilli@hotmail.com
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Andrilli
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
authors.forename: Giulio
authors.initials: G
authors.lastname: Maurizi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Muscogiuri
authors.forename: Rossella
authors.initials: R
authors.lastname: Baldini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: David
authors.forename: Federico
authors.initials: F
authors.lastname: Venuta
authors.forename: Erino A
authors.initials: EA
authors.lastname: Rendina
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001783:Blood Flow Velocity; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D016022:Case-Control Studies; D002417:Cattle; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D011013:Pneumonectomy / Q000379:methods; D011475:Prosthesis Failure; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000401:mortality; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology; D014683:Vena Cava, Superior / Q000473:pathology* / Q000601:surgery*
keywords: 10