Abstract
We present the case of a child with congenital heart disease repaired in infancy with diffuse central venous occlusions resulting in central venous insufficiency, superior vena cava (SVC) syndrome, and intracranial bleeds. He presented to the catheterization laboratory for multiple transcatheter interventions to recanalize central venous channels which were unsuccessful by conventional methods. Therefore, extravascular venous channels were created to decompress his upper body by creation of a neo-SVC and his lower body with a neo-azygos vein to the neo-SVC. The latter procedure required direct percutaneous access from a paraspinal approach in order to obtain continuity with the azygos vein. At latest follow-up the patient is clinically well and asymptomatic.
Keywords:
IVC syndrome; SVC syndrome; recanalization; revascularization; venous obstruction.
© 2019 Wiley Periodicals, Inc.
MeSH terms
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Azygos Vein / surgery*
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Cardiac Surgical Procedures* / adverse effects
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Child, Preschool
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Decompression, Surgical*
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Heart Defects, Congenital / diagnostic imaging
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Heart Defects, Congenital / physiopathology
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Heart Defects, Congenital / surgery*
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Humans
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Intracranial Hemorrhages / diagnostic imaging
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Intracranial Hemorrhages / etiology
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Intracranial Hemorrhages / physiopathology
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Intracranial Hemorrhages / surgery*
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Male
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Recovery of Function
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Superior Vena Cava Syndrome / diagnostic imaging
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Superior Vena Cava Syndrome / etiology
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Superior Vena Cava Syndrome / physiopathology
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Superior Vena Cava Syndrome / surgery*
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Surgically-Created Structures*
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Treatment Outcome
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Vascular Surgical Procedures*
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Vena Cava, Superior / diagnostic imaging
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Vena Cava, Superior / physiopathology
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Vena Cava, Superior / surgery*
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Venous Insufficiency / diagnostic imaging
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Venous Insufficiency / etiology
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Venous Insufficiency / physiopathology
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Venous Insufficiency / surgery*