Blindness with Superior Vena Cava Obstruction after Cardiac Surgery

Algethamy, Haifa; Nicolle, David A.; Novick, Richard J.; Saito, Aya; Young, G. Bryan

doi:10.1017/s0317167100051696

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“…One of these patients had an obstructive clot formed due to a stricture in the distal portion of the SVC and the other from scarring in the SVC-right atrial junction. [13] Both cases demonstrated bilateral swelling of the neck and head with diagnosis confirmed by CT.…”

Section: Discussionmentioning

confidence: 85%

An unusual cause of intraoperative acute superior vena cava syndrome

2013

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Acute intraoperative superior vena cava (SVC) syndrome is an exceedingly rare complication in the cardiac surgical population. We describe the case of a 71-year-old female undergoing multi-vessel coronary artery bypass grafting who developed acute intraoperative SVC syndrome following internal thoracic artery harvest retractor placement. Her symptoms included severe plethora, facial engorgement and scleral edema, which was associated with hypotension and severe elevation of central venous pressure. Transesophageal echocardiography was crucial in the diagnosis, management, and optimal retractor placement ensuring adequate SVC flow. Potential causes of intraoperative SVC syndrome are reviewed as well as management options.

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Section: Discussionmentioning

confidence: 85%