[The superior vena cava obstruction syndrome after the implantation of a permanent pacemaker: a clinical case report].

Occlusion of the superior vena cava is a rare but serious complication of transvenous endocardial pacing. We describe 1 case of superior vena cava obstruction associated with permanent transvenous DDD pacemaker, following local infection. Thrombolytic therapy was initially effective, resulting in relief of signs of obstruction. However systemic infection occurred 3 months later. The patient was subsequently submitted to surgical removal of the infected pacemaker apparatus. Several therapeutical options described in previous papers are reviewed: anticoagulants, thrombolytics, percutaneous dilatation, surgical removal of the catheter. In conclusion, when a chronic process induced by local infection is present, surgical treatment is the best therapeutical approach.