Reconstruction of the Superior Vena Cava Following Invasive Thymoma Resection by Monitoring Cerebral Oxygenation

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Invasive thymoma often invades adjacent organs, such as the pleura, lungs, pericardium, and great vessels; the superior vena cava and brachiocephalic vein are particularly susceptible. A 31-year-old woman was admitted after chemotherapy for invasive thymoma involving the superior vena cava and left brachiocephalic vein. During the operation, regional cerebral oxygenation was measured using the INVOS^TM5100C monitor to avoid adverse effects due to long-time total clamping of the superior vena cava because left brachiocephalic vein could not be reconstructed due to total occlusion of the distal lumen. We could decide if the SVC was safely clamped with this INVOS^TM5100C monitor. Then complete resection of the tumors was successfully performed, and a single artificial graft was used for reconstruction of the superior vena cava. Postoperative clinical course was uneventful, and she was discharged on the 18th postoperative day.