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

Invasive thymoma often invades adjacent organs, such as the pleura, lungs, pericardium, and great vessels; the superiorvena cava and brachiocephalic vein are particularly susceptible. A 31-year-old woman was admitted after chemotherapy forinvasive thymoma involving the superior vena cava and left brachiocephalic vein. During the operation, regional cerebral oxygenationwas measured using the INVOSTM5100C monitor to avoid adverse effects due to long-time total clamping of the superiorvena cava because left brachiocephalic vein could not be reconstructed due to total occlusion of the distal lumen. Wecould decide if the SVC was safely clamped with this INVOSTM5100C monitor. Then complete resection of the tumors was successfullyperformed, and a single artificial graft was used for reconstruction of the superior vena cava. Postoperative clinicalcourse was uneventful, and she was discharged on the 18th postoperative day