A 37 year-old male patient who had edema on neck, face and arms, dispnea, complaint of difficulty of working while bending was accepted to our department. In the physical examination there were edema on neck, face and arms, hyperemia in conjunctivae and venous collaterals at the anterior thoracic wall. Telecardiographic findings were nonspecific. There were calcifications in the area vena cava superior in the computed tomography. In upper the extremity flebogram, right subclavian vein and jugularis interna were partly visualized and left subclavian vein was completely occluded. Median sternotomy and subclavicular incision were made in the operation. The conjunction area of vena cava superior and innominate vein was hard. In the frozen histopatholojic examination there was no evidence of malignancy. Two subclavian-right atrial by-pass were made by using two separese 8 mm ringed PTFE grafts. On the other hand right internal juguler-right atrial bypass was done with a spiral vein graft prepared from saphenous vein. The grafts were patent on Doppler ultrasonogram.

Postoperative course showed uneventfulrecovery. The complaints of the patient decreased significantly. The patient was discharged on the 10th day.

In the selected cases of vena cava superior syndrome, successful results can be obtained by vascular reconstruction.