ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Ann Thorac Surg 2009;88:392-397. doi:10.1016/j.athoracsur.2009.04.068
© 2009 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Michael Lanuti
Henning A. Gaissert
Cameron D. Wright
John C. Wain
James S. Allan
Dean M. Donahue
Douglas J. Mathisen
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Google Scholar
Right arrow Articles by Lanuti, M.
Right arrow Articles by Mathisen, D. J.
PubMed
Right arrow Articles by Lanuti, M.
Right arrow Articles by Mathisen, D. J.
Related Collections
Right arrow Lung - cancer
Right arrow Mediastinum
Right arrowRelated Article

Original Articles: General Thoracic

Review of Superior Vena Cava Resection in the Management of Benign Disease and Pulmonary or Mediastinal Malignancies

Michael Lanuti, MD*, Pierre E. De Delva, MD, Henning A. Gaissert, MD, Cameron D. Wright, MD, John C. Wain, MD, James S. Allan, MD, Dean M. Donahue, MD, Douglas J. Mathisen, MD

Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts

Accepted for publication April 16, 2009.

* Address correspondence to Dr Lanuti, 55 Fruit St, Blake 1570, Boston, MA 01748 (Email: mlanuti{at}partners.org).

Presented at the Poster Session of the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009.

Background: Obstruction of the superior vena cava (SVC) by tumor or benign disease implies unreconstructable disease and poor outcome. We analyzed the operative results, graft patency, and survival in patients undergoing SVC resection and reconstruction for benign disease and pulmonary or mediastinal malignancy.

Methods: Patients undergoing SVC resection from 1997 to 2007 for surgical management of benign and invasive neoplasms were retrospectively reviewed.

Results: We identified 19 patients requiring SVC resection. Malignant disease was resected in 17: lung cancer in 9 and mediastinal malignancy in 8. Two patients (10%) with benign processes required reconstruction for chronic SVC syndrome. Ringed Gore-Tex conduit (W. L. Gore and Associates, Flagstaff, AZ) was used for 12 reconstructions (63%) of the SVC, and 7 patients underwent primary closure or autologous pericardial patch repair. Preoperative chemoradiotherapy was administered to 9 patients (53%). There was one perioperative death (5%). Major postoperative morbidities included atrial fibrillation in 5, stroke in 2, respiratory failure in 3, myocardial infarction in 1, and Horner syndrome in 1. Median survival for the entire cohort was 45.5 months (range, 0.2 to 147 months), with a mean follow-up of 45.8 months. Five-year survival probability was 30% for patients with resected lung cancer and 56% for patients with resected anterior mediastinal malignancies.

Conclusions: Resection and reconstruction may be safely performed in selected patients for benign and malignant obstruction or infiltration of the SVC. Survival and intermediate-term patency after tubular grafting of the SVC are acceptable.


Related Article

Invited commentary.

Ann. Thorac. Surg. 88: 397-398. [Full Text]



This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
L. Spaggiari
Invited commentary.
Ann. Thorac. Surg., August 1, 2009; 88(2): 397 - 398.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by The Society of Thoracic Surgeons.