Simultaneous lateral and subxiphoid access methods for safe and accurate resection of a superior vena cava aneurysm: A case report

Background: Superior vena cava (SVC) aneurysms are a relatively uncommon disease that has not been widely reported. The conventional surgical approach for treating SVC aneurysms includes open thoracotomy and mid-sternotomy. However, in this case, the aneurysm could be safely resected by thoracoscopic simultaneous lateral and subxiphoid access methods.

Case summary: A 58-year-old male presented with intermittent chest pain and persistent discomfort in the chest area. A chest computed tomography scan revealed a 6.2 cm aneurysm in the left innominate vein and SVC junction. For surgical resection, simultaneous lateral and subxiphoid access were planned to achieve optimal proximal and distal aneurysm control. The approach site was 1 cm below the xiphoid process, the fifth mid-axillary line and the seventh anterior axillary line on the right side. The aneurysm was resected using a stapler. The patient was discharged on the third day after chest tube removal on the second postoperative day with no particular issues.

Conclusion: Aneurysms located within the mediastinum can be accessed through thoracoscopic approach without open surgery and safely resected using vascular staples.