Work

Thrombectomy and Stenting for SVC Thrombosis in a Post–Heart Transplant Patient With Congenital Heart Disease

Year: 2025

Type: article

Abstract: BACKGROUND: Superior vena cava (SVC) thrombosis is a rare but potentially life-threatening complication after heart transplantation, particularly in patients with congenital heart disease and complex venous anatomy. CASE SUMMARY: A 44-year-old man with cyanotic congenital heart disease and bilateral SVC underwent heart transplantation with systemic venous reconstruction, including right SVC-to-donor SVC anastomosis and left SVC-to-right atrial appendage connection via Dacron graft. Twelve days post-transplant, he developed symptomatic extensive right SVC thrombosis. Given his high surgical risk, endovascular thrombectomy via femoral access was performed using the FlowTriever system. Angiography revealed 2 critical SVC stenoses treated successfully with angioplasty and stent implantation. DISCUSSION: This case highlights the feasibility and safety of large-bore thrombectomy and venous stenting in a heart transplant recipient with complex congenital anatomy. TAKE-HOME MESSAGE: Endovascular therapy offers a viable, minimally invasive alternative to surgery for post-transplant SVC thrombosis in patients with complex venous anatomy.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105856