[Reconstruction of the superior vena cava in trauma and thrombosis in a woman with a mediastinal tumor (case report)].

Presented herein is a clinical case report of successful treatment of an 18-year-old female patient with an iatrogenic injury and thrombosis of the superior vena cava having occurred during mediastinal tumor biopsy. While undergoing videothoracoscopy and mediastinal tumor biopsy she developed profuse bleeding from the superior vena cava. The vein defect together with the surrounding tissues was sutured during thoracotomy. This was complicated by the development of thrombosis of the superior vena cava and marked edema of soft tissues of the face, neck and upper half of the trunk. External jugular-femoral bypass turned out to be ineffective. A day later, she was subjected to reconstructive surgery. Complete removal of the mediastinal tumor, thrombectomy of brachiocephalic veins and reconstruction of the superior vena cava were performed from a sternotomy. For the reconstructive surgery, a spiral-shaped conduit from the great saphenous vein of the thigh was used. Within a day, complete regression of soft tissue edema of the face, neck and upper half of the torso was noted. After 15 months according to the data of CT angiography, the autovenous conduit was passable, with no signs of either thrombosis or restenosis. This is followed by a literature review of the modern state of the problem of treatment of patients with superior vena cava syndrome.