Two Case Reports of Emergency Stenting of Superior Vena Cava Obstruction Following Cardiac Surgery

Superior vena cava (SVC) obstruction is a recognized complication following cardiac surgery that may result in significant clinical sequelae if not treated early. Transcatheter stenting is rapidly becoming the treatment of choice, considering its reduced post-procedure morbidity and faster recovery time. In early postoperative vascular lesion, primary stenting is preferred over balloon angioplasty to prevent fresh suture line disruption. In paediatric, small patient sizes as well as the need for future vessel growth, complicate the use of stents in this group of patients. We present two cases of successful relief from severe SVC obstruction that occurred early after cardiac surgical repair. Case 1, is a 2-month-old girl with a large perimembranous ventricular septal defect (VSD) and patent ductus arteriosus (PDA), who underwent VSD closure and PDA ligation but was complicated by SVC tear during cannulation. Case 2 is a 35-year-old gentleman with a sinus venosus atrial septal defect, who underwent Warden procedure but developed SVC obstruction at SVC-right atrium anastomosis site. The presentation and management of these patients will be highlighted in these two cases.