Superior Vena Cava Syndrome and Otorrhagia During Cardiac Surgery

Abstract

Otorrhagia during cardiac surgery is rare. Otorrhagia combined with other signs of increased venous pressure in the upper body indicates the development of superior vena cava (SVC) syndrome. In this case, ear bleeding, facial engorgement, and conjunctival edema were noticed. The SVC cannula was displaced, leading to SVC syndrome. Repositioning of the cannula led to rapid recovery of the symptoms and an uneventful postoperative course. Providers should be vigilant about signs of SVC obstruction. Transparent coverings and surgical shelves should be used for constant examination of the head and neck to immediately detect changes.

A rare case of superior vena cava syndrome in a patient on VV-ECMO

“…There is one case report of SVC syndrome during VV-ECMO in an adult. In this case, the patient was cannulated with a double-lumen IJV cannula [ 8 ]. This patient had a background history of chronic kidney disease requiring haemodialysis indicating the possibility of central narrowing due to a previous catheter.…”

Superior vena cava syndrome during veno-venous extracorporeal membrane oxygenation for COVID-19

“…However, SVC syndrome resulting from intraoperative cannulation for cardiopulmonary bypass was previously described in patients undergoing cardiac surgery. 8,9 Identification of SVC syndrome in adults treated with VV ECMO requires a high index of suspicion. In our case, we established the diagnosis based on our patient's physical examination, the point-of-care ultrasound findings, and a passive leg raise test.…”

“…However, SVC syndrome resulting from intraoperative cannulation for cardiopulmonary bypass was previously described in patients undergoing cardiac surgery. 8,9…”