A case of pulmonary embolism after SVC replacement

Abstract

Resection and reconstruction of the superior vena cava and brachiocephalic vein are rarely required; as such, guidelines for their peri- and postoperative management do not currently exist. Rather, each is managed with an empirical anticoagulation regimen. A 60-year-old woman developed a pulmonary embolism on the 11^th day after prosthetic graft reconstruction for a mediastinal tumor because of graft thrombosis. Lacking the symptoms of upper body swelling and facial edema, her major complaint was respiratory discomfort, and contrast computed tomography revealed a defect. The postoperative pathological diagnosis was follicular lymphoma. There have been some reports on graft occlusion and stenosis, but reports on pulmonary embolism are rare. In this case, inadequate anticoagulant therapy was one cause of the pulmonary embolism. Pulmonary embolism after prosthetic graft reconstruction is rare; however, once it occurs, the clinical course is fatal. Adequate anticoagulant therapy in the early postoperative period is required in order to prevent the early-stage graft thrombosis, and we recommend graft patency evaluation before rising.