Superior vena caval thrombosis and recurrent pericarditis caused by a bronchogenic cyst

A 49-year-old man with a past history of multiple episodes of acute pericarditis was admitted with a recurrence of symptoms combined with the superior vena caval syndrome. A bronchogenic cyst, located beneath the carina, was discovered. At operation, the cyst was partially resected, and superior vena caval flow was restored by a Gore-Tex prosthesis. Ten months later the superior vena caval syndrome reappeared. Angiography demonstrated subtotal stenosis of the graft, which was considered to be thrombotic due to the discontinuance of oral anticoagulants. Reoperation, however, showed no thrombosis, but kinking of the graft. The folded portion of the prosthesis was resected, since when the patient has done well.