title: Acute, unanticipated, and prolonged superior vena cava occlusion during pneumonectomy.
abstract: Acute, unanticipated superior vena cava (SVC) occlusion during thoracic surgery can have profound hemodynamic consequences and lead to devastating neurologic injury. We describe the successful anesthetic management of a pneumonectomy complicated by prolonged intraoperative SVC occlusion lasting a total of 290 minutes. To our knowledge, this represents the longest reported SVC occlusion time with no subsequent neurologic sequelae. Based on our favorable outcome and a review of the relevant literature, we offer a discussion of strategies for anesthetic management.
authors.affiliation: Dept of Anesthesiology, Olive View-UCLA Medical Center, 14445 Olive View Drive, Sylmar, CA 91342; Dept of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095. Electronic address: mgoh2@dhs.lacounty.gov.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Goh
authors.affiliation: Dept of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095. Electronic address: VivekChellappa@mednet.ucla.edu.
authors.forename: Vivek
authors.initials: V
authors.lastname: Chellappa
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D062186:Arterial Pressure; D016063:Blood Loss, Surgical; D003097:Collateral Circulation; D003251:Constriction, Pathologic / Q000209:etiology* / Q000517:prevention & control; D006439:Hemodynamics; D006488:Hemostasis, Surgical / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000009:adverse effects*; D049268:Positron-Emission Tomography; D013479:Superior Vena Cava Syndrome / Q000503:physiopathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior / Q000473:pathology*