Surgical management of tumors invading the superior vena cava

Determining the appropriate surgical treatment for anterior mediastinal malignancies, especially those invading the superior vena cava, present a unique problem for thoracic surgeons. Various surgical methods can be applied to resect tumors that have invaded the superior vena cava without the use of cardiopulmonary bypass. The type of procedure used varies according to the size of the tumor and extent of invasion into adjacent structures. This can involve treatment ranging from a simple resection with primary repair to using a vascular shunt and graft interposition. We present a range of methods to approach surgical resection of tumors that have invaded the superior vena cava.