Percutaneous stenting for superior vena cava stenosis following surgical repair of congenital heart defects: A two case report

Abstract

Superior vena cava (SVC) stenosis is a rare but serious complication following surgical repair of congenital heart defects, often resulting in significant venous congestion, facial and upper extremity swelling, increased venous pressures, and impaired hemodynamics. Surgical re-intervention carries substantial risks, whereas percutaneous stenting offers a minimally invasive and effective alternative. We present two cases of symptomatic SVC stenosis following congenital heart defect repair. Both patients underwent detailed imaging with cardiac MRI and CT angiography, confirming severe SVC stenosis. Percutaneous intervention was performed using self-expanding Wallstents deployed under fluoroscopic guidance, with tailored post-dilation strategies to optimize luminal expansion. Immediate symptomatic relief was achieved in both cases, with complete resolution of venous congestion. Post-procedure anticoagulation included warfarin for six months, followed by long-term aspirin therapy. Follow-up imaging demonstrated sustained stent patency without restenosis or thrombosis. These cases highlight percutaneous stenting as a viable and effective approach for managing post-surgical SVC stenosis, offering a safe alternative to surgical re-intervention. Future research should focus on optimizing stent designs and post-procedural management strategies to further improve patient outcomes.