Fukushima K, Hasegawa T, Oohara T, Take A, Yamaguchi T, Saito K
Department of Thoracic and Cardiovascular Surgery, Jichi Medical School, Tochigi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Dec;40(12):2258-61.
This case report describes a 32-year-old male patient with superior vena cava syndrome due to chronic fibrosing mediastinitis involving superior vena cava, bilateral brachiocephalic, subclavian, and internal jugular veins. Although the ringed ePTFE graft was placed between left internal jugular vein and right atrium twice, it occluded each time. Pathological examination of the removed specimen showed invasion of the fibrous tissue into the lumen of the graft at the anastomotic site and severe fibroelastosis in the intima of the jugular vein. The third reconstruction of the venous system with the ringed ePTFE substitute was done in the same manner. Postoperative venography demonstrated the patent graft and the interruption at the midportion of the left internal jugular vein. The patient remains free from the symptoms one year and nine months after the last operation.
本病例报告描述了一名32岁男性患者，因慢性纤维性纵隔炎累及上腔静脉、双侧头臂静脉、锁骨下静脉和颈内静脉而患有上腔静脉综合征。尽管带环ePTFE移植物曾两次置于左颈内静脉与右心房之间，但每次均发生闭塞。对取出标本的病理检查显示，吻合部位的纤维组织侵入移植物管腔，颈内静脉内膜出现严重纤维弹性组织增生。采用带环ePTFE替代物对静脉系统进行的第三次重建以相同方式完成。术后静脉造影显示移植物通畅，左颈内静脉中段中断。在最后一次手术后一年零九个月，患者症状消失。
