Reconstruction of the superior vena cava in patients with mediastinal malignancies

We performed reconstruction of the superior vena cava (SVC) and left brachiocephalic vein following extensive resection of malignant thymic tumours in eight patients, five of whom had invasive thymoma. The other patients each had a thymic Hodgkin's lymphoma, thymic carcinoma and thymic germ cell tumour. Teflon grafts were used in the first two cases and expanded polytetrafluoroethylene (EPTFE) grafts in the subsequent six cases. Occlusion occurred only in one SVC graft and two left brachiocephalic vein grafts. The mean survival after this operation was 35 months, with the longest survivor showing no occlusive symptoms for 8 years. This operation not only alleviates the symptoms of the SVC syndrome but may also improve the prognosis of such patients.