Images in Cardiothoracic Medicine and Surgery
A rare cause of superior vena cava syndrome 25 years after cardiac surgery
Asian Cardiovascular & Thoracic Annals 2014, Vol. 22(6) 750 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313489563 aan.sagepub.com
Vasily I Kaleda, Pavel P Yablonski and Kirill O Barbuhatti
Figure 1. Computed tomography showing an ascending aortic aneurysm with a dissection and a false lumen compressing superior vena cava below vena azygos, a single fenestration in the posterior wall of the ascending aorta, and a small anterior false aneurysm. AAA: ascending aortic aneurysm, AFA: anterior false aneurysm; f: fenestration; FL: false lumen; SVC: superior vena cava; VA: vena azygos; VCs: venous collaterals.
A 65-year-old woman presented with acute chest pain, orthopnea, and facial and arm swelling. She had undergone aortic valve replacement with a ball-valve prosthesis, for significant rheumatic aortic valve stenosis, in another country 25 years earlier. Transthoracic echocardiography showed a complex ascending aortic aneurysm to be the cause of her superior vena cava syndrome. The prosthesis functioned well with a maximum gradient of 42 mm Hg. Computed tomography showed an ascending aortic aneurysm with a dissection and a false lumen compressing the superior vena cava below the azygos vein. There was a single fenestration in the posterior wall of the ascending aorta. Another finding was a small anterior false aneurysm (Figure 1A–D). Further surgery confirmed the
diagnosis. Histological examination of the aortic wall showed cystic medial necrosis. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflicts of interest statement None declared.
Krasnodar Regional Hospital #1, Chest Surgery Center, Krasnodar, Russia Corresponding author: Vasily I Kaleda, MD, 140 Rossiyskaya Str., Krasnodar, 350086, Russia. Email: [email protected]
Downloaded from aan.sagepub.com at ST PETER'S SEMINARY on March 26, 2015
A rare cause of superior vena cava syndrome 25 years after cardiac surgery
Asian Cardiovascular & Thoracic Annals 2014, Vol. 22(6) 750 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313489563 aan.sagepub.com
Vasily I Kaleda, Pavel P Yablonski and Kirill O Barbuhatti
Figure 1. Computed tomography showing an ascending aortic aneurysm with a dissection and a false lumen compressing superior vena cava below vena azygos, a single fenestration in the posterior wall of the ascending aorta, and a small anterior false aneurysm. AAA: ascending aortic aneurysm, AFA: anterior false aneurysm; f: fenestration; FL: false lumen; SVC: superior vena cava; VA: vena azygos; VCs: venous collaterals.
A 65-year-old woman presented with acute chest pain, orthopnea, and facial and arm swelling. She had undergone aortic valve replacement with a ball-valve prosthesis, for significant rheumatic aortic valve stenosis, in another country 25 years earlier. Transthoracic echocardiography showed a complex ascending aortic aneurysm to be the cause of her superior vena cava syndrome. The prosthesis functioned well with a maximum gradient of 42 mm Hg. Computed tomography showed an ascending aortic aneurysm with a dissection and a false lumen compressing the superior vena cava below the azygos vein. There was a single fenestration in the posterior wall of the ascending aorta. Another finding was a small anterior false aneurysm (Figure 1A–D). Further surgery confirmed the
diagnosis. Histological examination of the aortic wall showed cystic medial necrosis. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflicts of interest statement None declared.
Krasnodar Regional Hospital #1, Chest Surgery Center, Krasnodar, Russia Corresponding author: Vasily I Kaleda, MD, 140 Rossiyskaya Str., Krasnodar, 350086, Russia. Email: [email protected]
Downloaded from aan.sagepub.com at ST PETER'S SEMINARY on March 26, 2015
