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Ann Thorac Surg 2000;70:1720-1721
© 2000 The Society of Thoracic Surgeons

Case report

Management of empyema complicating lobectomy with superior vena cava replacement

Marco Alifano, MDa, Philippe Puyo, MDa, Pierre Magdeleinat, MDa, Philippe Levasseur, MDa, Jean François Regnard, MDa

a Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France

Address reprint requests to Dr Regnard, Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, 133 Av de la Resistance, 92350 Le Plessis Robinson, France
e-mail: jean-francois.regnard{at}htd.ap-hop-paris.fr

We present the case of a 49-year-old man with right upper lobe adenocarcinoma invading the right brachiocephalic vein and the origin of the superior vena cava. En bloc resection of right upper lobe with the involved venous segments was carried out through a median sternotomy. Venous pathway was reestablished with a Gore-Tex (W.L. Gore & Assoc, Flagstaff, AZ) prosthesis. Postoperative course was marked by right pneumonia complicated by empyema. The patient underwent thoracotomy with completion pneumonectomy and latissimus dorsi transposition to cover both the prosthesis and the bronchial stump, as well as to fill the cavity. A favorable outcome was observed and long-term survival achieved.




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