Seaton’s Story: Venous Thoracic Outlet Syndrome

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Seaton is a natural athlete, and basketball is his favorite sport. When he was a sophomore, he blossomed into a star on his high school basketball team and began thinking seriously about playing basketball in college. As a junior, he began drawing interest from Division III colleges.

Seaton in basketball uniform Seaton sought treatment at CHOP for a blood clot caused by venous thoracic outlet syndrome. A 6-foot-5 forward with a penchant for three-pointers, Seaton was determined to help his team make a run for the championship. The summer before his senior year, he ramped up his training, shooting hundreds of threes a day.

His plans took a very serious detour when, not long after the school year began, he tested positive for COVID-19. What was supposed to be a week or so of quarantine and rest became a frightening three-month ordeal.

While home from school recovering from COVID, Seaton awoke one day to find his right arm red and swollen. He didn’t think anything of it and didn’t tell anyone about it for a couple of days. But the swelling only worsened and it began to cause pain in his arm.

Blood clot from venous thoracic outlet syndrome

Seaton told his parents, Amanda and Stu, and they took him to the nearest emergency room at Einstein Medical Center. It just so happens that Einstein has a collaboration with Children’s Hospital of Philadelphia (CHOP) that creates a direct line to pediatric specialists at CHOP.

After undergoing testing, Seaton was diagnosed with a blood clot. A hematologist at Einstein was concerned and reached out to a pediatric hematologist at CHOP for consultation and, together, they decided to have Seaton transported to CHOP immediately.

Once at CHOP, Seaton was given blood thinners and admitted to the hospital. He underwent two minimally invasive surgeries to remove the blood clot.These procedures identified the root cause of the blood clot: venous thoracic outlet syndrome.

Venous thoracic outlet syndrome results from compression of the subclavian vein in the thoracic outlet, which is the space between the first (top) rib and the collarbone. This vein carries blood from the upper extremities — including the shoulders, arms and hands — to the heart. Compression of this vein can lead to significant upper extremity swelling and blood clots, which can travel to the heart and lungs and be life-threatening.

Full return to sports after first rib resection

Seaton winning basketball tournament Back on the court after successful rib resection surgery at CHOP. Venous thoracic outlet syndrome most commonly occurs in active teenagers and young adults. It can result from overuse of the arm and shoulder during sports.

Alexander S. Fairman, MD, Director of Pediatric Vascular Surgery at CHOP, met with Seaton and his parents to explain the condition. Unless the source of the vein compression was resolved, Seaton might  be unable to return to competitive sports.

Given Seaton’s goal to play basketball in college, Dr. Fairman recommended a first rib resection. In this surgery, the first rib on Seaton’s right side would be removed, which would alleviate compression of his  subclavian vein and mitigate the risk of future swelling and development of blood clots.

Four weeks after the blood clot was removed, Seaton returned to CHOP to undergo the rib resection procedure. He had to be on blood thinners for the next month and a half, so was unable to train or practice with his team during the preseason.

A week before the first game of the season, Seaton was cleared to start practicing and playing. Despite all he’d been through three months earlier, the captain led his team on an 11-game winning streak that season. To top it off, he scored 30 points in their championship win.

Seaton graduated having achieved his dream of high school basketball glory. He’s now living out another dream: playing Division III collegiate basketball!

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