Superior Vena Cava Stent Migration Into the Right Atrium

J INVASIVE CARDIOL 2020;32(3):E75.

Key words: cardiac imaging, echocardiography, stent removal

A 58-year-old male with recently diagnosed superior vena cava syndrome secondary to lymphoma underwent stenting with a 60 x 16 mm self-expanding Wallstent (Boston Scientific) in the superior vena cava for worsening of facial plethora and swelling of upper extremities. Two days post procedure, the patient returned to our facility with severe dyspnea and return of the original symptoms after reaching for an object on a nearby table. On physical examination, a new systolic murmur was noted in the fourth left intercostal space. The heart rate was 110 beats/min, with a blood pressure at 145/86 mm Hg. Frequent premature ventricular contractions were noted on electrocardiographic monitoring. Possible stent migration was suspected, which was confirmed on transesophageal echocardiography (Figures 1A and 1B; Videos 1 and 2). The patient underwent successful stent removal with snaring, as well as subsequent placement of another stent in the superior vena cava without further complications.

From the ¹Department of Anesthesiology, Mount Sinai Medical Center, Miami Beach, Florida; and ²Echocardiography Laboratory, Columbia University Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, Florida.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.

The authors report that patient consent was provided for publication of the images used herein.

Manuscript accepted April 22, 2019.

Address for correspondence: Orlando Santana, MD, Director, Echocardiography Laboratory, Columbia University Division of Cardiology, Mount Sinai Heart Institute, 4300 Alton Road, Miami Beach, FL 33140. Email: osantana@msmc.com