Journal of Cardiothoracic Surgery最新文献

{"title":"A novel technique of blindly positioning bronchial blockers for one-lung ventilation: a prospective, randomized, crossover study.","authors":"Seihee Min, Susie Yoon, Jiwon Han, Jeong-Hwa Seo, Jae-Hyon Bahk","doi":"10.1186/s13019-024-03276-8","DOIUrl":"10.1186/s13019-024-03276-8","url":null,"abstract":"<p><strong>Background: </strong>Several methods for blindly positioning bronchial blockers (BBs) for one-lung ventilation (OLV) have been proposed. However, these methods do not reliably ensure accurate positioning and proper direction. Here, we developed a clinically applicable two-stage maneuver by modifying a previously reported one-stage maneuver for successful insertion of a BB at the appropriate depth and direction in patients requiring lung isolation where a flexible bronchoscope (FOB) is not applicable.</p><p><strong>Methods: </strong>This prospective, randomized, crossover study was conducted at a tertiary university hospital and included 94 patients requiring OLV for elective thoracic surgery under general anesthesia. The patients underwent the one-stage maneuver followed by the two-stage maneuver and vice versa, and the success rates of the two methods were compared. After tracheal intubation, the deflated rigid-angle BB was inserted into the endotracheal tube (ET) until a pre-marked point indicating that the BB was just protruding from the ET tip. To identify the carinal depth without FOB, the BB balloon was inflated and advanced toward the intended side whilst monitoring abrupt changes in peak inspiratory pressure and expiratory tidal volume to indicate placement at the carina. In one-stage maneuver, the BB balloon was deflated and advanced 3 cm further from the estimated carinal depth. During the two-stage maneuver, the same procedure was performed to determine the carinal depth, and the deflated BB was withdrawn and reinserted to a predetermined depth with its tip directed 90 degree toward the target bronchus. The accuracy of BB positioning for both maneuvers was evaluated by a 4-point scale, with grades 1 and 2 considered acceptable for providing OLV.</p><p><strong>Results: </strong>BB placement was more accurate in the two-stage maneuver than in the one-stage maneuver [88.0% (81/92) vs. 73.9% (68/92), relative risk (95% confidence interval [CI]), 0.45 (0.23-0.88), P < 0.001]. This improvement was particularly significant when targeting the left main bronchus [84.8% (39/46) vs. 58.7% (27/46), relative risk (95% CI), 0.36 (0.17-0.79), P < 0.001)].</p><p><strong>Conclusions: </strong>The novel two-stage maneuver significantly improved the success rate of blindly positioning the BB.</p><p><strong>Trial registration: </strong>This study was registered in ClinicalTrials.gov (NCT02981537) on December 05, 2016.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"50"},"PeriodicalIF":1.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic lumen repair with glue-felt technique before proximal anastomosis in acute type a aortic dissection surgery.","authors":"Muhammed Varol, Berk Arapi, Çiğdem Tel Üstünışık, Deniz Göksedef, Suat Nail Ömeroğlu, Gökhan İpek, Ozan Onur Balkanay","doi":"10.1186/s13019-024-03227-3","DOIUrl":"10.1186/s13019-024-03227-3","url":null,"abstract":"<p><strong>Objectives: </strong>Despite the advances in medicine, aortic dissection remains a cardiac surgery emergency with high mortality and morbidity rates. This study examined the effects of the Glue + Felt technique, which uses biological glue and felt to repair the proximal anastomotic site, on the outcomes of patients with acute type A aortic dissection.</p><p><strong>Methods: </strong>A total of 108 patients who underwent surgery for acute type A aortic dissection at our clinic between 2007 and 2020 were included in the study. The patients were divided into two groups: the \"Glue + Felt Technique\" and the \"Bentall-De Bono\" groups, based on the surgical technique used for the aortic root. The effects of these two techniques on the development of intraoperative and postoperative complications and survival rates were statistically analyzed.</p><p><strong>Results: </strong>The Glue + Felt technique was used for 76 patients, while the Bentall-De Bono technique was used for 32 patients. The Kaplan-Meier analysis revealed significant differences in survival rates between the two groups over the entire follow-up period, both with and without propensity score matching (p < 0.001 and p = 0.02, respectively). However, no significant differences were observed in comparisons beyond the first 30 days of follow-up, either with or without propensity score matching (p = 0.573 and p = 0.561, respectively). The main factors contributing to this difference were the duration of cardiopulmonary bypass and aortic cross-clamp time (p < 0.05). During the average follow-up period of 46.2 ± 31.6 months, no re-intervention was required in patients from the Glue-Felt technique group.</p><p><strong>Conclusions: </strong>The mortality rate in aortic dissection surgery is higher with more extensive surgical intervention as the duration of cardiopulmonary bypass and aortic cross-clamp time increases. Repairing the lumen and reducing operation time in suitable patients using the Glue-Felt technique for the proximal anastomotic site positively impacts postoperative complications and improves in-hospital and 30-day survival rates, without increasing long-term re-intervention rates.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"46"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of intrathoracic Gauzoma.","authors":"Taishi Adachi, Hidenao Kayawake, Hiroshi Hamakawa, Yutaka Takahashi","doi":"10.1186/s13019-024-03264-y","DOIUrl":"10.1186/s13019-024-03264-y","url":null,"abstract":"<p><strong>Background: </strong>Gauzoma is a foreign body reactive granuloma which is an extremely rare complication of thoracic surgery. We describe a case of a Gauzoma in which the gauzes were removed by mini-thoracotomy as a less invasive procedure, discovered incidentally after 35 years of follow-up.</p><p><strong>Case presentation: </strong>A 51-year-old man was referred to our department for hyperhidrosis treatment, and imaging studies and biopsy confirmed the diagnosis of Gauzoma. As the Gauzoma gradually grew for a few years, surgical intervention was judged necessary, and the removal of the gauzes was performed in this case. A two-stage operation in two days was required to complete the surgery. The completion of gauze removal was confirmed in the second surgery using a postoperative computed tomography (CT) scan. The patient is currently doing well 17 months after surgery, and the size of granuloma unchanged.</p><p><strong>Conclusion: </strong>We performed the removal of the gauzes as the treatment for Gauzoma. Although removing the gauze may have prevented its growth so far, careful follow-up is still needed.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"47"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11716325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography-guided microwave ablation therapy for pediatric adrenal neuroblastoma with lung nodule a case report.","authors":"Shu-Cong Peng, Jing-Xiao Li, Kun-Lin He, Guo-Sheng Li, Gui-Yu Feng, Xu He, Yue Li, Guan-Qiang Yan, Xiang Gao, Shang-Wei Chen, Jun Liu, Nuo Yang","doi":"10.1186/s13019-024-03307-4","DOIUrl":"10.1186/s13019-024-03307-4","url":null,"abstract":"<p><strong>Background: </strong>Solid lung lesions are common in clinical practice, and percutaneous thermal ablation has been shown to be an effective treatment for these lesions. While computed tomography (CT)-guided microwave ablation (MWA) therapy is frequently used for adult solid lesions, it is rarely considered for pediatric cases.</p><p><strong>Case presentation: </strong>A case of an 8-year-old child with adrenal neuroblastoma and a left upper lung mass. The child successfully underwent lung mass ablation and experienced a long-term progression-free period with good recovery and no recurrence.</p><p><strong>Conclusions: </strong>This case suggests that MWA could be a valuable addition to existing treatment options for solid lesions in children.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"45"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy and hemodynamic effects of levosimendan in cardiac surgery patients after surgery.","authors":"Meiling Zhao, Yunfeng Hou, Meng Yuan, Shuang Ma, Yifeng Yue","doi":"10.1186/s13019-024-03316-3","DOIUrl":"10.1186/s13019-024-03316-3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the therapeutic effect of levosimendan on hemodynamics in patients undergoing major cardiac surgery and presenting with acute postoperative heart failure.</p><p><strong>Methods: </strong>The subjects of the study were 160 patients with severe cardiac conditions who underwent surgery and had acute heart failure. Eighty cases each were assigned to the research and control groups using a random number table. Document the general patient data for each of the two groups; compare the clinical outcomes of the two groups. The hemodynamic states of the two groups were compared both before and after therapy. 48 h after surgery, echocardiography was performed in both groups to determine cardiac function. 48 h after surgery, N-terminal pro-brain B-type natriuretic peptide (NT-Pro-BNP) levels were compared between the two groups.</p><p><strong>Results: </strong>The overall effective rate was significantly higher in the research group (92.5%) compared to the control group (76.25%, P < 0.05). Post-treatment, the research group demonstrated a significant reduction in CVP (9.25 ± 2.11 cmH2O vs. 11.36 ± 3.08 cmH2O, P < 0.001), heart rate (100.30 ± 8.69 bpm vs. 105.74 ± 7.69 bpm, P < 0.001), and lactic acid levels (1.68 ± 0.59 mmol/L vs. 2.69 ± 0.55 mmol/L, P < 0.001). The research group also showed improvements in SBP (117.23 ± 8.74 mmHg vs. 113.25 ± 7.55 mmHg, P = 0.002) and urine output (4.21 ± 1.76 mL/kg/h vs. 3.65 ± 1.23 mL/kg/h, P = 0.021). Cardiac function indicators 48 h after surgery indicated a higher LVEF (55.21 ± 8.04% vs. 47.18 ± 6.60%, P < 0.001) and lower LVEDVi and LVESVi in the research group (P < 0.001 for both). NT-Pro-BNP levels were significantly lower in the research group (6010.19 ± 1208.52 pg/mL vs. 9663.21 ± 2391.34 pg/mL, P < 0.001). The incidence of complications was lower in the research group (5% vs. 22.5%, P = 0.001).</p><p><strong>Conclusion: </strong>Cardiac surgery patients are prone to complications with acute heart failure after surgery. Treatment with levosimendan can significantly improve clinical efficacy and reduce complications. It can also effectively improve patients' cardiac function and promote hemodynamic stability.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"43"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anomalous drainage of lingular vein into left inferior pulmonary vein during thoracoscopic lung cancer surgery.","authors":"Chenyang Guo, Yadi Zhang, Haoqian Zheng, Xing Wei, Wei Dai, Qiang Li","doi":"10.1186/s13019-024-03323-4","DOIUrl":"https://doi.org/10.1186/s13019-024-03323-4","url":null,"abstract":"<p><strong>Background: </strong>The intricate anatomical variations in lung structure often perplex thoracic surgeons, and the accurate identification of these variations is closely associated with favorable surgical outcomes.</p><p><strong>Case presentation: </strong>A 53-year-old female patient who underwent computed tomography (CT) examination due to chest discomfort, revealing the presence of a partial solid nodule highly suspected of early-stage lung cancer, measuring approximately 2.8 × 2.6 cm in the left lower lobe. Consequently, the patient underwent a single direction thoracoscopic left lower lobectomy and lymph node dissection. Intraoperatively, while attempting to dissect and free the left lower lobe vein from surrounding tissues, technical difficulties were encountered. Upon meticulous review of preoperative CT scans during surgery, an anomalous connection between the lingular vein of the left upper lobe and the left lower lobe vein was identified. Once this anatomical variation was confirmed, surgical intervention proceeded uneventfully without any significant complications.</p><p><strong>Conclusion: </strong>Precise recognition of pulmonary anatomical structures before and during surgery is paramount in recognizing rare variations such as this one as it aids in preventing potential intraoperative injuries and minimizing postoperative complications.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"36"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary pulmonary meningioma: a case report and literature review.","authors":"Jun Cheng, Chunfen Guo","doi":"10.1186/s13019-024-03259-9","DOIUrl":"https://doi.org/10.1186/s13019-024-03259-9","url":null,"abstract":"<p><strong>Introduction: </strong>Primary pulmonary meningioma is a rare disease. There have been only a little over 50 cases of primary pulmonary meningioma (PPM) reported in previous literature. The pathogenesis of PPM is still unclear. We report a case of PPM cured by thoracoscopic right middle lobe wedge resection and systematically review previously reported cases in previous literature.</p><p><strong>Case report: </strong>A 57-year-old male patient was found to have a nodule in the right middle lobe of about 1.8 cm in diameter on a chest-enhanced CT scan performed more than 7 years ago. A re-examination in 2023 found the subpleural nodule in the right middle lobe had grown larger than before. Considering surgical treatment, the patient underwent a thoracoscopic right middle lobe wedge resection after a thorough examination. The final pathological diagnosis was primary pulmonary meningioma. Regular follow-up CT scans showed no recurrence.</p><p><strong>Conclusion: </strong>Primary pulmonary meningioma is a rare tumor that occurs in sites similar to lung cancer. Most cases are solitary, presenting as ground-glass nodules (GGO), and can occur in multiple lobes, involving the mediastinum and pleura with multiple nodules. Clinical and radiological diagnoses are often challenging, especially distinguishing from primary lung cancer. Surgery remains the optimal choice for the diagnosis and treatment of PPM. Most cases are benign with a good prognosis, and wedge resection is usually the preferred surgical approach. A small proportion of malignant cases may require lobectomy and adjuvant radiotherapy and chemotherapy due to tumor invasiveness.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"44"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with hospital length of stay in patients with thoracic hydatid cyst disease undergoing surgical intervention: a retrospective study.","authors":"Reza Ershadi, Mohammadreza Salehi, Ghazal Roostaei, Niloofar Khoshnam Rad, Sara Soltanmohammadi, Hesam Amini","doi":"10.1186/s13019-024-03291-9","DOIUrl":"10.1186/s13019-024-03291-9","url":null,"abstract":"<p><strong>Background: </strong>Hydatid cyst (HC) frequently affects the lungs, making it the second most common site after the liver. This study evaluated the clinical characteristics, surgical procedures, complications, laboratory findings, and factors influencing hospital length of stay (LOS) in patients undergoing surgery for pulmonary hydatid cysts.</p><p><strong>Methods: </strong>This retrospective observational study included adult patients who underwent surgery for lung HC between 2017 and 2021. Data were collected using a standardized checklist covering demographics, medical history, clinical symptoms, laboratory findings, treatment details, surgical characteristics, and risk factors. The primary outcome was LOS, defined as the duration between surgery and discharge.</p><p><strong>Results: </strong>A retrospective analysis of 214 patients with pulmonary hydatid cysts revealed a male predominance (59.3%; median age, 36 years). The most common symptom was cough (39.3%), followed by chest pain and dyspnea. Right lower lobe involvement (51.4%) and synchronous liver cysts (13.6%) were frequently observed. Elevated erythrocyte sedimentation rate (ESR), eosinophilia, positive serology, prolonged air leak, and fever were correlated with longer LOS. The dominant surgical procedure was cystotomy with capitonnage (95.8%), performed via thoracotomy.</p><p><strong>Conclusions: </strong>Most hydatid cysts were located in the right lower lobe, with cough being the most frequent presenting symptom. Thoracotomy and cystotomy with capitonnage were the primary surgical procedures performed. Common postoperative complications included wound infection, empyema, and prolonged air leak. Awareness of factors such as elevated ESR, eosinophilia, positive serology, prolonged air leak, and fever may improve management and reduce hospital LOS.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"39"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic and prognostic value of serum miR-199a-5p combined with echocardiography in acute myocardial infarction.","authors":"Lixin Xu, Jianfeng Lin, Jianke Xia, Deng Chen, Guohan He","doi":"10.1186/s13019-024-03201-z","DOIUrl":"https://doi.org/10.1186/s13019-024-03201-z","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis and prognostic evaluation of acute myocardial infarction (AMI) are crucial for patients.</p><p><strong>Objective: </strong>The clinical significance of serum miR-199a-5p combined with echocardiography in AMI was investigated to provide some reference for clinical treatment.</p><p><strong>Methods: </strong>The study subjects were 90 AMI patients and 50 acute chest pain patients (control). All patients were examined by echocardiography and recorded LVEDV, LVESV, and LVEF. RT-qPCR was performed to detect the serum miR-199a-5p level. Pearson analysis was used to analyze the correlation of miR-199a-5p with LVEF and cTnI. The diagnostic value of miR-199a-5p combined with LVEDV, LVESV, and LVEF was assessed by the ROC curve. The occurrence of major adverse cardiovascular events (MACE) was recorded to analyze the prognostic value of miR-199a-5p by the Kaplan-Meier curve and Cox regression.</p><p><strong>Results: </strong>Serum miR-199a-5p was elevated in AMI, positively correlated with cTnI and negatively correlated with LVEF. The combination of miR-199a-5p with LVEDV, LVESV, and LVEF enhanced the sensitivity and specificity for the diagnosis of AMI. Patients with high miR-199a-5p expression were more likely to develop MACE. The combination of miR-199a-5p with LVEF improved the prediction of MACE.</p><p><strong>Conclusions: </strong>The combination of miR-199a-5p with echocardiography improved the diagnostic efficiency of AMI and provided prognostic information.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"42"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal management and complete resection of invasive Type B3 thymoma with vascular reconstruction: a case report.","authors":"Puiyee Sophia Chan, Akshay J Patel, Gianluca Lucchese, Andrea Bille","doi":"10.1186/s13019-024-03318-1","DOIUrl":"https://doi.org/10.1186/s13019-024-03318-1","url":null,"abstract":"<p><strong>Introduction: </strong>Thymomas and thymic carcinomas are rare anterior mediastinal tumours, accounting for 0.2-1.5% of all cancers. Surgical resection is key to treatment, though invasion of surrounding structures like great vessels can complicate this. This case report details the management of a type B3 thymoma (T4 N0 M0) in a 41-year-old male.</p><p><strong>Case report: </strong>A 41-year-old male presented with myasthenic symptoms and was diagnosed with a large thymic mass involving the brachiocephalic vein and superior vena cava. After 4 cycles of neoadjuvant chemotherapy, partial resection was performed, followed by radiotherapy. Residual disease led to a second surgery, during which tumour resection and vascular reconstruction using cardiopulmonary bypass were successfully completed. Postoperative recovery was uneventful.</p><p><strong>Discussion: </strong>Complete resection, including re-resection, when necessary, is crucial for improved outcomes in thymoma patients. Even with great vessel invasion, aggressive surgery, coupled with chemotherapy and vascular reconstruction, can achieve good survival outcomes.</p><p><strong>Conclusion: </strong>Multimodal management, including chemotherapy, complete resection, and vascular reconstruction, offers the best prognosis for invasive thymomas, even with great vessel involvement.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"40"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}