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Superior vena caval reconstruction using autologous pericardium.
W Piccione1, L P Faber, W H Warren
1Department of Cardiovascular-Thoracic Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, Illinois.
The Annals of Thoracic Surgery
|September 1, 1990
Summary
Superior vena cava (SVC) tumor involvement necessitates surgical resection, potentially including the caval wall. A technique using an intraluminal shunt and autologous pericardium for reconstruction allows for adequate tumor margins.
Area of Science:
- Cardiovascular Surgery
- Thoracic Oncology
- Surgical Oncology
Background:
- Superior vena cava (SVC) involvement by thoracic tumors presents a surgical challenge.
- Tumor extension can arise from primary thoracic malignancies or metastatic lymph nodes in the superior mediastinum.
- Resection of the SVC wall may be necessary to achieve complete tumor removal with clear margins.
Purpose of the Study:
- To describe a surgical technique for managing superior vena cava (SVC) tumor involvement.
- To detail the use of an intraluminal shunt and autologous pericardium for SVC reconstruction.
- To facilitate radical resection of tumors involving the SVC.
Main Methods:
- Placement of an intraluminal shunt to maintain SVC blood flow during resection.
- Resection of the segment of the superior vena cava (SVC) infiltrated by tumor.
- Reconstruction of the SVC wall using a pericardial graft (autologous pericardium).
Main Results:
- The described technique allows for the resection of SVC segments involved by tumor.
- Successful reconstruction of the SVC wall using autologous pericardium is achieved.
- This method enables the attainment of adequate surgical margins in complex oncologic resections.
Conclusions:
- Surgical management of superior vena cava (SVC) tumor involvement is feasible.
- The described shunt and pericardial reconstruction technique is a viable option for SVC resection.
- This approach can improve oncologic outcomes for patients with SVC-invading tumors.