[Superior vena cava replacement with autologous pericardial conduit in redo cardiac surgery].

BACKGROUND

Iatrogenic lesions needing repair can occur during redo cardiac surgery. Lacerations of the superior vena cava in redo cardiac surgery have been underreported. There is still debate around what prosthesis is best to replace the superior vena cava. A case of superior vena cava replacement for iatrogenic injury in a case of redo mitral valve surgery is reported. Use of fresh autologous pericardium to create a total conduit restoring the continuity of the superior vena cava is described.

CLINICAL CASE: 54-year-old female with previous cardiac surgery undergoing prosthetic mitral valve replacement. During the course of the procedure, a major laceration in the superior vena cava was detected and successfully repaired by interposing a total conduit of fresh autologous pericardium.

CONCLUSIONS

Use of autologous pericardium in order to make a total conduit for the superior vena cava reconstruction can be recommended because no long-term anticoagulation is required, and there is no additional economical cost and virtually no risk of infection.