Reconstruction using a pericardial tube and ringed Gore-Tex graft for malignant superior vena cava syndrome: report of two cases.

Superior vena cava (SVC) syndrome caused by malignant tumors in the upper mediastinum is not uncommon. Radiation therapy or endovascular treatment with stenting is the first choice of treatment to relieve symptoms. However, surgical treatment may be considered when the less invasive treatment modalities failed. In this report, we present two cases of severe symptomatic SVC syndrome as a result of invasive thymomas, which were treated successfully using a composite graft made by pericardial tube and ringed polytetrafluorethylene (PTFE) graft. Symptoms soon subsided after operation. The patients were symptom free at 8 months and 24 months after the surgical management, respectively. In this report, we also reviewed reports in the literature relating to the surgical management in SVC syndrome. Based on our limited experience in these cases, we think that bypass with pericardial tube could be an effective palliative treatment technique offering durable clinical symptom relief for SVC symptoms caused by malignant tumors in certain cases.