Kim SP, Son J. Simultaneous lateral and subxiphoid access methods for safe and accurate resection of a superior vena cava aneurysm: A case report. World J Clin Cases 2023; 11(31): 7635-7639 [PMID: 38078138 DOI: 10.12998/wjcc.v11.i31.7635]
Corresponding Author of This Article
Joohyung Son, MD, Assistant Professor, Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Geumo-ro 20, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Republic of Korea, Yangsan-si 50612, South Korea. pnumed09@naver.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2023; 11(31): 7635-7639 Published online Nov 6, 2023. doi: 10.12998/wjcc.v11.i31.7635
Simultaneous lateral and subxiphoid access methods for safe and accurate resection of a superior vena cava aneurysm: A case report
Sang Pil Kim, Joohyung Son
Sang Pil Kim, Department of Thoracic and Cardiovascular Surgery, Kyunghee University Hospital, Seoul 02447, South Korea
Joohyung Son, Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan-si 50612, South Korea
Author contributions: Son J contributed to manuscript writing; Kim SP contributed to manuscript and figure editing; all authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for the publication of the findings of the present case study and related images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joohyung Son, MD, Assistant Professor, Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Geumo-ro 20, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Republic of Korea, Yangsan-si 50612, South Korea. pnumed09@naver.com
Received: July 13, 2023 Peer-review started: July 13, 2023 First decision: September 25, 2023 Revised: October 10, 2023 Accepted: October 23, 2023 Article in press: October 23, 2023 Published online: November 6, 2023 Processing time: 116 Days and 6.2 Hours
Abstract
BACKGROUND
Superior vena cava (SVC) aneurysms are a relatively uncommon disease that has not been widely reported. The conventional surgical approach for treating SVC aneurysms includes open thoracotomy and mid-sternotomy. However, in this case, the aneurysm could be safely resected by thoracoscopic simultaneous lateral and subxiphoid access methods.
CASE SUMMARY
A 58-year-old male presented with intermittent chest pain and persistent discomfort in the chest area. A chest computed tomography scan revealed a 6.2 cm aneurysm in the left innominate vein and SVC junction. For surgical resection, simultaneous lateral and subxiphoid access were planned to achieve optimal proximal and distal aneurysm control. The approach site was 1 cm below the xiphoid process, the fifth mid-axillary line and the seventh anterior axillary line on the right side. The aneurysm was resected using a stapler. The patient was discharged on the third day after chest tube removal on the second postoperative day with no particular issues.
CONCLUSION
Aneurysms located within the mediastinum can be accessed through thoracoscopic approach without open surgery and safely resected using vascular staples.
Core Tip: Superior vena cava (SVC) aneurysms, which are relatively rare, may be symptomatic or cause thrombotic events if large in size, often necessitating surgical intervention. The conventional surgical approach for treating SVC aneurysms includes open thoracotomy and mid-sternotomy. However, in this case, the aneurysm could be safely resected by thoracoscopic simultaneous lateral and subxiphoid access methods. The approach site was 1 cm below the xiphoid process, the fifth mid-axillary line and the seventh anterior axillary line on the right side. To facilitate surgery, CO2 insufflation was used. The aneurysm was safely resected with the use of a vascular staple.
