Superior Vena Cava Syndrome Due to Right Anterior Mediastinal Hematoma: A Case Report

Ibrahim, Ramy; Yadav, Swarada; Waqar, Sumaita; Hermann, Jose Ruben; Sarwar, Abeer; Shah, Sundeep

doi:10.7759/cureus.26994

Cited by 2 publications

(2 citation statements)

References 9 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hematoma, caused by the leaking of blood from an aneurysmectomy/aneurysmorrhaphy site, is listed among common postoperative complications of CABG; but not as a cause of post-CABG TdP. Hematoma, alone, is an important complication, as it can rarely compress the heart and arteries and may even cause superior vena cava syndrome ( 26 ) and tamponade, which lead to shock and death in the patients ( 27 ). Therefore, diagnosis is essential; previous studies have suggested CT scan as an accurate diagnostic tool for post-CABG epicardial and retrosternal hematoma formation ( 28 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

Retrosternal hematoma causing torsade de pointes after coronary artery bypass graft surgery; a case report

Sharifkazemi,

Ghazinour,

Lotfi

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Myocardial infarction is among the top causes of mortality worldwide. Survivors may also experience several complications. Infarct-related torsade de pointes (TdP) is an uncommon complication. In the context of myocardial infarction, coronary artery bypass graft (CABG) surgery is the prevalent therapeutic modality associated with several early and late complications. Ventricular tachyarrhythmias, including TdP, because of electrical inhomogeneity, would potentially be a lethal complication of CABG. Here, we report the occurrence of medically intractable TdP in the presence of an uncommon case of a post-CABG retrosternal hematoma. Arrhythmia was properly resolved after hematoma removal surgically. It showed the possibility of a “cause and effect” relationship between these two complications. This unique case emphasizes the post-CABG medically-resistant TdP, considering the mechanical pressure effect of retrosternal hematoma that stimulates this potentially malignant arrhythmia, especially in the absence of electrolyte disturbances and evident symptoms of ongoing ischemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Retrosternal hematoma causing torsade de pointes after coronary artery bypass graft surgery; a case report

Sharifkazemi,

Ghazinour,

Lotfi

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…We know that tunneled CVC tip positioning in the RSVC outside the right atrium is associated with fibrin sheath formation and increased risk of thrombosis and central venous stenosis [ 18 ], and current NKF-KDOQI recommendations suggest placement of the tip in the mid right atrium [ 15 ]. However, in a patient with PLSVC, catheter tip malposition into the coronary sinus is also a known complication with increased risk of thrombosis, acute coronary syndrome, and potentially fatal arrhythmia [ 19 - 21 ], which we believe can outweigh the risk of central venous stenosis of the PLSVC. It is important to consider that any further manipulation or replacement of the CVC initially placed in the coronary sinus also increases the risk of perforation with cardiac tamponade [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Accidental Diagnosis of Isolated Persistent Left Superior Vena Cava After an Elective Central Venous Access Procedure for Chronic Hemodialysis: Clinical Implications and Precautions From a Case Report

Coimbra,

Braga,

Silva

et al. 2023

Cureus

View full text Add to dashboard Cite

Persistent left superior vena cava (PLSVC) is the most frequent thoracic venous anatomical variant in the general population. Isolated PLSVC, without formation of the right superior vena cava, is described in 10% of cases of PLSVC only. While it can be associated with congenital heart disease, arrhythmias, and premature death, adult patients with PLSVC are mostly asymptomatic, and the diagnosis is usually accidental. We present the case of a 72-year-old male with end-stage renal disease who was started on urgent hemodialysis through a temporary non-tunneled femoral central venous catheter (CVC) in the SLED (slow low-efficiency dialysis) modality and later remained dependent on hemodialysis. At this stage, placement of a tunneled CVC in the right internal jugular vein was necessary and fluoroscopy guidance was not available. There were no complications during the procedure, but postoperative conventional chest radiography revealed an inadequate positioning of the CVC tip in the left hemithorax, crossing the midline. Subsequently, the diagnosis of PLSVC was obtained by performing a thoracic angio-CT scan, confirming CVC tip positioning inside the PLSVC, and also excluded the presence of cardiac defects or additional anatomical variations of the great vessels of the thorax. Early evaluation for the creation of autologous vascular access was started under our care, and there were no mechanical or other complications associated with hemodialysis sessions during early follow-up after discharge.

show abstract

Superior Vena Cava Syndrome Due to Right Anterior Mediastinal Hematoma: A Case Report

Cited by 2 publications

References 9 publications

Retrosternal hematoma causing torsade de pointes after coronary artery bypass graft surgery; a case report

Retrosternal hematoma causing torsade de pointes after coronary artery bypass graft surgery; a case report

Accidental Diagnosis of Isolated Persistent Left Superior Vena Cava After an Elective Central Venous Access Procedure for Chronic Hemodialysis: Clinical Implications and Precautions From a Case Report

Contact Info

Product

Resources

About