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Ann Thorac Surg 1998;65:263
© 1998 The Society of Thoracic Surgeons

Case Reports

Resection of a Pulmonary Malignancy Invading the Intrapericardial Inferior Vena Cava

John R. Roberts, MD, Patti S. Abbott, PA, W. Roy Smythe, MD, Joseph E. Bavaria, MD

Division of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA

Accepted for publication September 5, 1997.

Dr Roberts, Department of Cardiac and Thoracic Surgery, Vanderbilt University School of Medicine, 2986 The Vanderbilt Clinic, Nashville, TN 37232-5734.

Resection of extensive lung cancers invading thoracic vascular structures (T4 lesions) can yield long-term survival provided the margins and nodes are free of tumor. We report the resection of the suprahepatic inferior vena cava for direct tumor involvement by a pulmonary malignancy. The resection was performed without bypass, and the cava was subsequently reconstructed with a 22-mm-diameter Dacron graft. Patency was documented on postoperative magnetic resonance angiograms. The patient was discharged home on postoperative day 10 without complications and remains well 8 months after the operation. Potentially curative resections and reconstructions of suprahepatic inferior vena cava involved with pulmonary malignancies are possible and can be done without cardiopulmonary bypass.






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