Abstract
Objective: We retrospectively analyzed reconstructive procedures, kinds of grafts used, antithrombotic therapy, and graft patency in patients with thoracic malignancies and resection of the superior vena cava (SVC) and brachiocephalic veins (BCVs).
Methods: From 2005 to 2014, 15 patients underwent resection and reconstruction of SVC and/or BCVs. We collected and reviewed their clinical data, surgical procedures, postoperative graft status, and perioperative antithrombotic therapy.
Results: The subjective tumors were thymic epithelial tumor in 11 patients, germ cell tumor in two, and lung cancer and malignant lymphoma in one each. SVC was reconstructed in 13 patients, right BCV in 12 patients, and left BCV in 14 patients. In all patients, the adopted graft diameter was ≥10 mm and antithrombotic therapy was performed. Although occlusion of the reconstructed veins was observed in six patients, the associated symptoms were rarely observed in patients whose left and right brachiocephalic pathways were maintained.
Conclusion: Procedures that require the resection of great vessels remain challenging. We did not observe perioperative deaths nor early graft occlusions in this study. In the case of graft occlusion, follow-up is possible in the absence of severe symptoms.
