• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.36-40
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• 2013

Caval syndrome is a life threatening condition caused by heavy worm burden in right cardiac chambers including right atrium, right ventricle, and vena cava and results in mechanical interference in tricuspid valvular excursion and blood flow to lower pulmonary arteries. A mechanical worm removal is the choice of option for treating this condition in dogs. In this study, we developed a new mechanical worm removal method using modified extraction brushes for treating dogs with caval syndrome. With this newly developed method, we successfully removed heartworms in two dogs with caval syndrome. Although the number of cases applied was small, authors found this method can be a good alternative retrieval method for mechanical worm removal in dogs.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.673-678
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• 1985

A 21 year-old male patient had a diagnosis of Budd-Chiari syndrome caused by inferior vena caval obstruction. Conservative medical therapy failed to control the symptoms of both portal hypertension and inferior vena caval stasis. Portocaval or mesocaval shunts may relive the symptoms of chronic forms of Budd-Chiari syndrome. But when inferior vena caval stenosis is severe, another procedure has to be used. Cavoatrial or portoatrial shunt has been suggested. Therefore, a long Dacron graft was placed from the inferior vena cava just below the left renal vein to the right atrium. He exhibited almost complete relief of symptoms for 1.5 year postoperatively. And there was angiographic proof of patency of the graft. This simple procedure should be encouraged in treatment of these patients.

• Tuberculosis and Respiratory Diseases
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• v.41 no.6
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• pp.676-679
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• 1994

A 36-year-old man was studied because of signs and symptoms of superior vena caval syndrome. Chest computerized tomography showed $10{\times}8{\times}6$ cm sized lobulated anterior mediastinal mass, compressing superior vena cava. Fine needle aspiration cytology revealed seminoma. There was no detectable tumor mass in the testes. We report a case of primary mediastinal seminoma presenting with superior vena caval syndrome.

• Journal of Veterinary Science
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• v.24 no.4
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• pp.46.1-46.12
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• 2023

Background: Heartworm infection in dogs is caused by Dirofilaria immitis and common in shelter animals and outdoors dogs. Caval syndrome can develop with severe infection and physical heartworm removal is essential with heartworm burdens. In this study, we used an improved transvenous heartworm extraction brush, which was expected to cause less cardiovascular damage and allow easier manipulation. Objectives: This study aims to evaluate efficacy of this improved transvenous heartworm extraction brush. Methods: The brush was designed to improve upon the limitations of the previous brush-type devices. The brush was made of a polyvinyl chloride tube and threads of polyamides or polyglyconates. Metal material was inserted at the front tip for easy visualization under fluoroscopy. The eight dogs diagnosed with caval syndrome with large numbers of heartworms and pulmonary hypertension were used in this study. The removal procedure began with the dissection of the subcutaneous tissue around the right jugular vein. The device was inserted through the jugular vein. After insertion, the tube was rotated to catch the heartworms and extracted with the heartworms hanging on the threads. The procedure was repeated several times. Lastly, jugular vein and skin sutures were made. Adulticidal therapy was administered after heartworm removal. Results: The mean number of removed heartworms was 10.5 ± 4.24 and mean number of remaining heartworms was 0.63 ± 1.06. Total procedure time was 72.63 ± 51.36. Except for three cases, heartworms were not detected on ultrasonography after the procedure. No procedure-related side effects were observed within the 1- to 2-mon. Conclusions: An improved transvenous heartworm extraction brush is efficient for heartworm removal in dogs with caval syndrome.

• The Korean Journal of Nuclear Medicine
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• v.22 no.1
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• pp.47-53
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• 1988

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows : 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.297-303
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• 2001

A female pug was presented with severe anemia, dyspnea and hemoglobinuria. By B- and M-mode echocardiography, the large number of heartworm were founded in the right ventricle, right atrium and pulmonary artery. The heartworm mass was moved from the right ventricle to the right atrium with the motion of the tricuspid value. Paradoxic septum motion were visible in M-mode of left ventrcular outflow tract and chordae tendineae level short-axis view. Flattened interventricular septum was find in B-mode of papillary muscle level short-axis view. In autopsy, 81 adult heartworms and 7 filarial debris were found. Most of adult heartworm were found in the right ventricle and pulmonary artery. 3 of them were found in the venaca and right atrium, respectively.

• Journal of Chest Surgery
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• v.12 no.2
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• pp.140-144
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• 1979

This is a report of a case of superior vena caval syndrome due to idiopathic mediastinal fibrosis, which was surgically treated. The patient was 35-year-old Korean male who progressively complained shortness of breath about for 40 days prior to operation. Phlebogram of SVC showed indentation of SVC at the site of cavoatrial junction. The operation was performed under impression of bronchogenic cancer of right hilum. After thoracotomy, it was found a irregular mass in the mediastinum at the level of cavoatrial junction, which was developed to surrounding with SVC, pericardium, trachea and bronchus and they fixed together to immobile. Bypass graft between SVC and right atrial appendage was performed using a pericardial roll tube This is a report of a case of superior vena caval syndrome due to idiopathic mediastinal fibrosis, which was surgically treated. The patient was 35-year-old Korean male who progressively complained shortness of breath about for 40 days prior to operation. Phlebogram of SVC showed indentation of SVC at the site of cavoatrial junction. The operation was performed under impression of bronchogenic cancer of right hilum. After thoracotomy, it was found a irregular mass in the mediastinum at the level of cavoatrial junction, which was developed to surrounding with SVC, pericardium, trachea and bronchus and they fixed together to immobile. Bypass graft between SVC and right atrial appendage was performed using a pericardial roll tube [$1.3{\times}5$ cm]. After that SVC was decompressed very well. SVC pressure was markedly reduced from 32 cm $H_2O$ in preoperative to 21 cm $H_2O$in postoperative. Mediastinal fibrosis was confirmed by histopathological examination postoperatively. The postoperative course was uneventful.

• Journal of Veterinary Clinics
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• v.39 no.4
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• pp.177-184
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• 2022

Caval syndrome is a severe complication of canine heartworm disease in which affected dogs present with various clinical signs that are often life-threatening. In cases of severe infection, adulticidal treatment has numerous complications as a result of a marked immune response against dead worms. Therefore, several surgical and non-surgical methods, including interventional extraction, have been applied in veterinary medicine. Despite the usefulness and efficiency of conventional retrieval devices, a few associated limitations must be addressed to reduce their risks and increase their applicability. Herein, we introduced a case of treating three dogs with caval syndrome by applying a newly developed heartworm basket device. The dogs were diagnosed with heartworm disease by heartworm antigen testing and direct smear. Imaging findings revealed remarkable remodeling of the right heart and pulmonary vessels and the presence of heartworms in the right heart. Additionally, heartworms were confirmed in the distal part of the abdominal aorta and femoral arteries in one dog, indicating aberrant systemic migration of the worms. Under general anesthesia, the heartworm basket device was introduced into the right heart via femoral venotomy and arteriotomy in one dog and jugular venotomy in the other two dogs. Although the number of cases in this study was small, the basket device was successful in gradual and cautious extraction of the heartworms in all three dogs. They exhibited good prognosis of clinical symptoms as indicated by imaging analyses.

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.368-371
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• 2004

Superior vena cava syndrome(SVCS) is most often encountered in patients with malignancies. Tuberculosis is nowadays an uncommon cause of SVCS. We report the case of a patient who presented with respiratory symptoms accompanied by SVCS due to tuberculous lymphadenitis. Treatment was instituted with isoniazid, rifampicin, pyrazinamide and ethambutol, and all symptoms disappeared. To our knowledge, no case of SVCS provoked by tuberculous lymphadenitis has been described previously in Korea.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1550-1555
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• 1992

From June 1989 to July 1992, we used centrifugal Biomedicus pump[CBP] in 20 patients In 9 cases, CBP was used as ventricular assistance after heart surgery for those who could not be weaned off bypass even with intra-aortic balloon counter-pulsation and with maximal inotropic support In 8 patients, CBP was used as partial left heart bypass during repair of aortic aneurysms or congenital aortic anomalies. And in 3 patients, CBP was used as vena caval bypass during resection of renal cell carcinoma with tumor extension into the inferior vena cava. In 2 of 9 patients with ventricular assistance, they were weaned off the device successfully after 16 hours and 7 days respectively. But the patients died of intracranial hemorrhage and sepsis, 7 and 29 days after weaning from cardiac support, respectively. In all the patients who underwent aortic of vena caval surgery using CBP as shunt, there were no complications such as postoperative bleeding necessitating reoperation, renal failure or neurologic sequelae. In conclusion, the centrifugal type of ventricular assistance may be potentially life saving treatment modality in patients with severe postoperative low cardiac output syndrome. The CBP can be safely employed for resection of renal cell carcinoma with vena caval tumor extension and for repair of aortic aneurysms.