The Journal of Thoracic and Cardiovascular Surgery, Vol 78, 116-118, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Compression of superior vena cava associated with aneurysmal dilatation of left atrium
NP Silverton, RD Thomas and MI Ionescu
A patient with rheumatic mitral valve disease and persistently elevated
jugular venous pressure (JVP) is described. Angiography revealed a
valve-like structure in the superior vena cava (SVC) at the site where a
pressure gradient was recorded. At operation, this previously unreported
anomaly proved to have been caused by aneurysmal dilatation of the left
atrium which exerted traction on the pericardial insertion to the SVC.
Disinsertion of the pericardial attachment to the vena cava at the time of
mitral valve replacement released the compression. Postoperatively, the JVP
became normal.