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Ann Thorac Surg 2006;82:310-312
© 2006 The Society of Thoracic Surgeons

Case report

Management of Superior Vena Cava Syndrome by Internal Jugular to Femoral Vein Bypass

Rajinder Singh Dhaliwal, MS, MCh, Debasis Das, MS, MCh * , Suvitesh Luthra, MS, MCh, Jaswinder Singh, MS, Sudhir Mehta, MS, Harkant Singh, MS

Department of Cardiovascular and Thoracic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Accepted for publication August 29, 2005.

* Address correspondence to Dr Das, Department of Cardiovascular and Thoracic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, PIN, 160012 India (Email: dasdeba{at}yahoo.com).

We report a 30-year-old man with superior vena cava syndrome due to fibrosis from a previously irradiated malignant thymoma. The patient presented 4 years after the initial treatment, after having been lost to follow-up. Investigations revealed total obstruction of the superior vena cava, and right subclavian and right internal jugular vein. The patient underwent an extra-anatomic bypass (ringed polytetrafluoroethylene graft 10-mm diameter) between the left internal jugular vein and the left femoral vein brought in a subcutaneous tunnel over the anterior chest and abdominal wall. Entry to the thoracic cavity was avoided due to extensive fibrotic changes visualized in the computed tomographic chest scan. Follow-up Doppler at 2 months, 6 months, 1 year, and 3 years showed a patent graft. An internal jugular vein to the femoral vein bypass is a simple method for palliation of superior vena cava syndrome.




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L. D. Wilson, F. C. Detterbeck, and J. Yahalom
Superior Vena Cava Syndrome with Malignant Causes
N. Engl. J. Med., May 3, 2007; 356(18): 1862 - 1869.
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