A CASE OF BILATERAL AXILLO-FEMORAL BYPASS FOR SUPERIOR VENA CAVAL SYNDROME CAUSED BY THYMOMA

Abstract

A 45-year-old man was admitted to hospital with the chief complaint of dyspnea. Phlebography showed obstructions of the superior vena cava and left brachiocephalic vein. Percutaneous needle biopsy led to a diagnosis of thymoma. Since the mass was considered unresectable, bilateal axillo-femoral bypass was performed by using prosthetic grafts made of spinal supported EPTFE (expanded polytetrafluoroethylene). After surgery patient's condition was dramatically improved, however, postoperative irradiation and chemotherapy were beyond for saving his life and the patient died on 120th postoperative day.The patient was free from superior vena caval syndrome on his postoperative course, the prosthetic grafts being considered efficatious for remission of distress and prolongation of his life. Seventy-eight cases of reconstruction of the superior vena cava using Prosthetic graft have been reported in Japan during the last 5 years. This report also reviewed the graft patency depending on reconstruction sites and prosthetic materials in 61 grafts of 43 cases that made reference to the graft patency in the reported 78 cases.