Surgical Outcomes after Superior Vena Cava Reconstruction with Expanded Polytetrafluoroethylene Grafts
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- Nakano Tomoyuki
- Department of General Thoracic Surgery, Jichi Medical University Saitama Medical Center, Omiya, Saitama, Japan Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
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- Endo Shunsuke
- Department of General Thoracic Surgery, Jichi Medical University Saitama Medical Center, Omiya, Saitama, Japan Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
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- Kanai Yoshihiko
- Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
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- Otani Shinichi
- Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
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- Tsubochi Hiroyoshi
- Department of General Thoracic Surgery, Jichi Medical University Saitama Medical Center, Omiya, Saitama, Japan
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- Yamamoto Shinichi
- Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
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- Tetsuka Kenji
- Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
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抄録
Objectives: Graft occlusion is a problem after superior vena cava (SVC) reconstruction for thoracic malignancy. Expanded polytetrafluoroethylene (ePTFE) is considered to be an optimal material for venous reconstruction.<br>Methods: We reviewed the hospital records of 13 patients who underwent complete resection of thoracic malignancy invading the SVC, including SVC reconstruction with ePTFE grafts. Single bypass grafting was performed in two patients (one right-sided, one left-sided) and double bypasses grafting was performed in the other patients. All patients received antithrombotic therapy after surgery. Eight patients died of recurrence or other disease during the follow-up period (range 5–41 months).<br>Results: Of the 24 grafts in 13 patients, graft patency was confirmed in 20 grafts in 9 patients at a mean time follow-up time of 47.8 ± 50.0 months after surgery. In the remaining four grafts in four patients, occlusion was diagnosed at a mean time of 1.25 ± 0.50 months after surgery. All obstructed grafts were left-sided bypass grafts in patients who underwent double bypass grafting, and did not result in SVC syndrome.<br>Conclusions: SVC reconstruction with ringed ePTFE grafts was safe and had good outcomes. In patients who underwent double bypasses grafting, the left-sided bypass grafts were susceptible to occlusion.
収録刊行物
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 20 (4), 310-315, 2014
Annals of Thoracic and Cardiovascular Surgery 編集委員会