Complex Surgical Interventions in Superior Vena Cava Syndrome

  • Zhen-Dong Gu
  • Ke-Neng Chen


The superior vena cava (SVC) originates from both brachiocephalic veins and returns the blood of upper half body into the right atrium. When the obstruction of SVC happens, blood stasis develops in the head, neck, and upper extremities, then the superior vena cava syndrome (SVCS) shows up. Most of the time, SVCS is associated with malignancies, such as advanced lung cancer, thymic tumors, metastatic solid tumors, and so on [1]. This chapter is dedicated to discussing the treatment, especially the complex surgical interventions, for SVCS.


Inferior Vena Cava Superior Vena Cava Thymic Carcinoma Brachiocephalic Vein Superior Vena Cava Syndrome 


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  1. 1.
    Chen JC, Bongard F, Klein SR (1990) A contemporary perspective on superior vena cava syndrome. Am J Surg 160:207–211PubMedCrossRefGoogle Scholar
  2. 2.
    Deslauriers J, Mehran R (2005) Handbook of perioperative care in general thoracic surgery. Mosby Inc., PhiladelphiaGoogle Scholar
  3. 3.
    Chen KN, Xu SF, Gu ZD et al (2006) Surgical treatment of complex malignant anterior mediastinal tumors invading the superior vena cava. World J Surg 30:162–170PubMedCrossRefGoogle Scholar
  4. 4.
    Wright CD, Mathisen DJ (2001) Mediastinal tumors: Diagnosis and treatment. World J Surg 25:204–209PubMedCrossRefGoogle Scholar
  5. 5.
    William EW Jr (1995) Thymoma. In: Pearson FG, Deslauriers J, Ginsberg RJ et al (eds) Thoracic surgery. Churchill Livingstone, New York, pp 1419–1427Google Scholar
  6. 6.
    Rosenberger A, Adler O (1978) Fine needle aspiration biopsy in the diagnosis of mediastinal lesions. AJR Am J Roentgenol 131:239–242PubMedGoogle Scholar
  7. 7.
    Bacha EA, Chapelier AR, Macchiarini P et al (1998) Surgery for invasive primary mediastinal tumors. Ann Thorac Surg 66:234–239PubMedCrossRefGoogle Scholar
  8. 8.
    Yagi K, Hirata T, Fukuse T et al (1996) Surgical treatment of invasive thymoma, especially when superior vena cava is invaded. Ann Thorac Surg 61:521–524PubMedCrossRefGoogle Scholar
  9. 9.
    Ahmann F (1984) A reassessment of the clinical implications of the superior vena cava syndrome. J Clin Oncol 2:961–969PubMedGoogle Scholar
  10. 10.
    Doty JR, Flores JH, Doty DB (1999) Superior vena cava obstruction: Bypass using spiral vein graft. Ann Thorac Surg 67:1111–1116PubMedCrossRefGoogle Scholar
  11. 11.
    Dartevelle PG, Chapelier AR, Pastorino U et al (1991) Long-term follow-up after prosthetic replacement of the superior vena cava combined with resection of mediastinal-pulmonary malignant tumors. J Thorac Cardiovasc Surg 102:259–265PubMedGoogle Scholar
  12. 12.
    Funakoshi Y, Ohta M, Maeda H et al (2003) Extended operation for invasive thymoma with intracaval and intracardiac extension. Eur J Cardiothorac Surg 24:331–333PubMedCrossRefGoogle Scholar
  13. 13.
    Curran WJ Jr, Kornstein MJ, Brooks JJ et al (1998) Invasive thymoma: The role of mediastinal irradiation following complete or incomplete surgical resection. J Clin Oncol 6:1722–1727Google Scholar
  14. 14.
    Park BJ, Bacchetta M, Bains MS et al (2004) Surgical management of thoracic malignancies invading the heart or great vessels. Ann Thorac Surg 78:1024–1030PubMedCrossRefGoogle Scholar
  15. 15.
    Magnan PE, Thomas P, Giudicelli R et al (1994) Surgical reconstruction of the superior vena cava. Cardiovasc Surg 2:598–604PubMedGoogle Scholar
  16. 16.
    Spaggiari L, Thomas P, Magdeleinat P et al (2002) Superior vena cava resection with prosthetic replacement for non-small cell lung cancer: Long-term results of a multicentric study. Eur J Cardiothorac Surg 21:1080–1086PubMedCrossRefGoogle Scholar
  17. 17.
    Kalra M, Gloviczki P, Andrews JC et al (2003) Open surgical and endovascular treatment of superior vena cava syndrome caused by nonmalignant disease. J Vasc Surg 38:215–223PubMedCrossRefGoogle Scholar
  18. 18.
    Pearl ML, Buhl A, DiSilvestro PA et al (2002) Superior vena cava syndrome. Prim Care Update Ob Gyns 9:160–163CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Zhen-Dong Gu
    • 1
  • Ke-Neng Chen
    • 1
  1. 1.Department of Thoracic Surgery IPeking University School of Oncology Beijing Cancer HospitalBeijingChina

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