Korean J Anesthesiol.  2012 Dec;63(6):550-554. 10.4097/kjae.2012.63.6.550.

Central venous catheter-related superior vena cava syndrome following renal transplantation: A case report

• Seo M
• Shin WJ
• Jun IG

• KMID: 2236258
• DOI: http://doi.org/10.4097/kjae.2012.63.6.550

Abstract

A 55-year-old man with end-stage renal disease had severe left ventricular dysfunction and a history of deep vein thrombosis. He underwent renal transplantation, during which a central venous catheter was inserted into the right jugular vein. The central venous pressure (CVP) exceeded 20 mmHg throughout the operation but there was no other adverse event. After surgery, although the left ventricular dysfunction improved, the CVP remained high. On postoperative day 10, the patient presented with cyanosis of the arms and redness of the face and was diagnosed with superior vena cava (SVC) syndrome, for which he underwent emergency thrombectomy and SVC reconstruction. The clinical course of this patient suggests that his end-stage renal disease-associated hypercoagulable state may have promoted thrombus formation. Moreover, placing the central venous catheter tip too deep may have encouraged thrombus formation. Repositioning the tip may have prevented this complication.

Keyword

Central venous catheter; Renal transplantation; Superior vena cava syndrome; Thrombus

MeSH Terms

Arm
Central Venous Catheters
Central Venous Pressure
Cyanosis
Emergencies
Humans
Jugular Veins
Kidney Failure, Chronic
Kidney Transplantation
Middle Aged
Superior Vena Cava Syndrome
Thrombectomy
Thrombosis
Vena Cava, Superior
Venous Thrombosis
Ventricular Dysfunction, Left