title: Immediate postoperative percutaneous stenting of superior vena cava obstruction following heart transplantation in adult patients with pacemaker leads.
abstract: Vena cava superior syndrome is a serious complication after heart transplantation, leading to low cardiac output, cerebral edema, and multi-organ dysfunction. We report three adult patients who underwent heart and heart-lung transplantation and required immediate postoperative balloon angioplasty and stent placement by interventional radiology. The observed obstructions were located at sites of intraoperatively removed pacemaker or defibrillator wires. Percutaneous stent placement immediately improved the hemodynamic condition of the patients. Early recognition of the complication and availability of immediate intervention are essential to prevent further deterioration.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Stanford University School of Medicine, Stanford, California.
authors.forename: David
authors.initials: D
authors.lastname: Asseff
authors.forename: Ahmad Y
authors.initials: AY
authors.lastname: Sheikh
authors.forename: Daniel
authors.initials: D
authors.lastname: Sze
authors.forename: Richard
authors.initials: R
authors.lastname: Ha
authors.forename: Lawrence
authors.initials: L
authors.lastname: Hofmann
authors.forename: Pieter J A
authors.initials: PJ
authors.lastname: van der Starre
mesh_terms: D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods; D020878:Device Removal / Q000009:adverse effects*; D057510:Endovascular Procedures / Q000379:methods*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D015641:Radiography, Interventional; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000209:etiology / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000601:surgery*