JACC. Case reports · 2025
Thrombectomy and Stenting for SVC Thrombosis in a Post-Heart Transplant Patient With Congenital Heart Disease.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Basile Mattia, Jiménez-Valero Santiago, De la Osa Guillermo, Rivero-Santana Borja, Zubiaur-Zamacola Jon, Tébar-Márquez Daniel, Gonzálvez-García Ariana, Galeote Guillermo, Jurado-Román Alfonso, Moreno Raúl
Аннотация
BACKGROUND: Superior vena cava (SVC) thrombosis is a rare but potentially life-threatening complication after heart transplantation, particularly in patients with congenital heart disease and complex venous anatomy.
CASE SUMMARY: A 44-year-old man with cyanotic congenital heart disease and bilateral SVC underwent heart transplantation with systemic venous reconstruction, including right SVC-to-donor SVC anastomosis and left SVC-to-right atrial appendage connection via Dacron graft. Twelve days post-transplant, he developed symptomatic extensive right SVC thrombosis. Given his high surgical risk, endovascular thrombectomy via femoral access was performed using the FlowTriever system. Angiography revealed 2 critical SVC stenoses treated successfully with angioplasty and stent implantation.
DISCUSSION: This case highlights the feasibility and safety of large-bore thrombectomy and venous stenting in a heart transplant recipient with complex congenital anatomy.
TAKE-HOME MESSAGE: Endovascular therapy offers a viable, minimally invasive alternative to surgery for post-transplant SVC thrombosis in patients with complex venous anatomy.
CASE SUMMARY: A 44-year-old man with cyanotic congenital heart disease and bilateral SVC underwent heart transplantation with systemic venous reconstruction, including right SVC-to-donor SVC anastomosis and left SVC-to-right atrial appendage connection via Dacron graft. Twelve days post-transplant, he developed symptomatic extensive right SVC thrombosis. Given his high surgical risk, endovascular thrombectomy via femoral access was performed using the FlowTriever system. Angiography revealed 2 critical SVC stenoses treated successfully with angioplasty and stent implantation.
DISCUSSION: This case highlights the feasibility and safety of large-bore thrombectomy and venous stenting in a heart transplant recipient with complex congenital anatomy.
TAKE-HOME MESSAGE: Endovascular therapy offers a viable, minimally invasive alternative to surgery for post-transplant SVC thrombosis in patients with complex venous anatomy.