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Ann Thorac Surg 2008;86:1383. doi:10.1016/j.athoracsur.2007.11.004
© 2008 The Society of Thoracic Surgeons
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Images in Cardiothoracic Surgery

Giant Aortic Aneurysm as a Rare Cause of Superior Vena Cava Syndrome

Victor Dayan, MD*, Virginia Michelis, MD, Alvaro Lorenzo, MD

Department of Cardiology and Cardiovascular Surgery of the Clinic Hospital, Montevideo, Uruguay

* Address correspondence to Dr Dayan, 26 de Marzo 3459 Ap 602, Montevideo, 11300, Uruguay (Email: vdayan{at}adinet.com.uy).

An 82-year-old man presented at the emergency department with a 2-month history of dyspnea as well as facial and arm swelling. Physical examination confirmed the swelling and found upper extremity plethora and cyanosis. Results of laboratory tests were all normal, and the Venereal Disease Research Laboratory test result was negative.

A roentgenogram showed a wide mediastinum. An echocardiogram revealed an ascending aortic aneurysm of 105 mm. Both atria were collapsed by the aneurysm. No aortic regurgitation was detected. The computed tomography scan confirmed the aortic aneurysm starting at the sinotubular segment and affecting the tubular portion of the ascending aorta. Its maximum diameter was 110 mm. There was evidence of significant compression of the superior vena cava (SVC) and right atrium (Fig 1). Compression of these cavities was assumed as the etiologic agent of the superior vena cava syndrome in this patient.


Figure 1
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