Surgery set for SVC Syndrome

• by BrynaR
• 2010-08-08 01:08:22
• Surgery & Recovery
• 2068 views
• 4 comments

Hi Friends!

Just giving a quick update. To recap for those who do not remember me, I developed superior vena cava syndrome after my fifth ablation for inappropriate sinus tach. I was supposed to get a pacemaker during the last ablation but the EP was able to keep me from going into a junctional rhythm, so for the time being I am pacer free. However a few weeks ago I started to have sinus pauses; I will be getting a pacer after all.

Since my last post I made the decision to head to Cleveland Clinic to see a specialist here in regards to intervention for the SVC syndrome. Things are complicated even further by the fact that I will be needing a pacemaker, which will have to be put in epicardially. Before this visit I had only had a CT to confirm the SVC occlusion so the Doctors here ordered a transesophageal echo. This revealed quite a bit more.

Basically my SVC is closed to about 3mm by scar tissue. The closure is right at the SVC/right atrium junction. In addition to that, I have a small fistula (tear) where my SVC and right pulmonary vein touch. Evidently during one of my ablations the catheter delivering the RF came close to where the right pulmonary vein and the svc meet. While that healed the scar tissue created this hole.

I was told that surgery would be the safest option. The fear with an angioplasty is that the fistula would cause the vein to rupture, resulting in a fatality. I am scheduled to have open heart surgery to repair the superior vena cava on August 24. At that time they will also put in the pacemaker. They will be using a homograft (frozen tissue from a cadaver, probably an artery that will be cut to fit) for the patch.

I have not met with the surgeon yet, just spoken with his nurse. The week before surgery I will have several tests including an MRI and a catheterization to investigate this fistula. I will meet with the Surgeon after that so he can describe in detail what his plan is.

It has not really hit me that I will be having open heart surgery in 2 weeks! It is just so surreal that all this is happening in the first place! I had already come to terms with the fact that I will be needing a pacer... now I just have to understand the implications of an epicardial lead verses endo in regards to followup care, etc.

I will continue to keep you all posted! I do this just incase someone else out there is going through something similar, so they can read about my experience. There is very little on the internet about this!

As always, thanks for all the support and caring you offer:-)

Bryna