Thrombectomy and Stenting for SVC Thrombosis in a Post-Heart Transplant Patient With Congenital Heart Disease

Superior vena cava (SVC) thrombosis is a rare but potentially life-threatening complication after heart transplantation, particularly in patients with congenital heart disease and complex venous anatomy.

A 44-year-old man with cyanotic congenital heart disease and bilateral SVC underwent heart transplantation with systemic venous reconstruction, including right SVC-to-donor SVC anastomosis and left SVC-to-right atrial appendage connection via Dacron graft. Twelve days post-transplant, he developed symptomatic extensive right SVC thrombosis. Given his high surgical risk, endovascular thrombectomy via femoral access was performed using the FlowTriever system. Angiography revealed 2 critical SVC stenoses treated successfully with angioplasty and stent implantation.

This case highlights the feasibility and safety of large-bore thrombectomy and venous stenting in a heart transplant recipient with complex congenital anatomy.

Endovascular therapy offers a viable, minimally invasive alternative to surgery for post-transplant SVC thrombosis in patients with complex venous anatomy.