J.Jpn. Surg. Soc.. 79(12): 1499-1504, 1978

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Original article

A CASE OF SUPERIOR VENA CAVA SYNDROME DUE TO BEHÇET'S DISEASE TREATED BY RIGHT INNOMINATE VEIN TO SUPERIOR VENA CAVA ANASTOMOSIS

A-36-year-old man was admitted with the diagnosis of superior vena cava (SVC) syndrome caused by Behçet's disease. Marked venous distension of the bilateral lateral chest wall and moderate edema of the face and neck were noted. Venogram showed obstruction of the distal portion of the SVC and the entire innominate vein on the left side, demonstrating an increased collateral venous pattern.
The SVC and the origin of the bilateral innominate vein adhered with the adjacent organs were exposed through a midline sternotomy incision. The one-centimeter long SVC obstructed was resected remaining the obstructed left innominate vein, and right innominate vein to SVC anastomosis was performed. Postoperatively clinical symptoms were improved, although moderate stenosis of the reconstructed portion of the SVC was noted by postoperative venography.
A few cases of surgically treated SVC syndrome secondary to Behçet's disease has been reported, and that, the long term patency of the reconstructed SVC has not been obtained. Surgical reconstruction of the SVC, however, should be performed in the patient with moderate or severe clinical symptoms.

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