Duan Chao, Wu Haibo, Xing Fei, Lang Matthias, Agrafiotis Apostolos C, Takamori Shinkichi, Yamada Yosuke, Shanshal Mohamed, Zhou Chuanjiang
Department of Cardiothoracic Surgery, Benxi Central Hospital, Benxi, China.
Department of Cardiovascular Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
J Thorac Dis. 2025 Jul 31;17(7):5260-5267. doi: 10.21037/jtd-2025-1189. Epub 2025 Jul 4.
Left innominate vein aneurysm (LIVA) is a rare condition with an unclear cause. Only a few cases of this entity have been reported, and standard therapeutic guidelines for its diagnosis and treatment have not yet been established. There is no consensus about the optimal surgical access, thoracotomy may be the preferred method of treatment.
A 55-year-old male who was tentatively diagnosed with invasive thymoma via thoracic computed tomography (CT) was ultimately diagnosed with left innominate venous aneurysm via contrast-enhanced thoracic CT. The patient was asymptomatic. He was operated through a median sternotomy. A saccular left innominate venous aneurysm was discovered intraoperatively, and instead of reconstruction with a vascular graft or cardiopulmonary bypass (CPB), it was treated with allogeneic pericardium placed with continuous horizontal mattress sutures and sternotomy closure. The procedure was successful, with no major bleeding event; to our knowledge, this is the first reported use of allogeneic pericardium with continuous horizontal mattress sutures for this condition. The postoperative course and follow-up were unremarkable, with no need for anticoagulant therapy and no evidence of recurrence observed at the 1-year follow-up.
Left innominate venous aneurysm is easily misdiagnosed as invasive thymoma and can be definitively diagnosed via enhanced thoracic CT examination or magnetic resonance imaging (MRI). This novel approach may offer valuable insights for guiding future therapeutic strategies.
左无名静脉瘤（LIVA）是一种病因不明的罕见病症。仅有少数该病症的病例被报道，其诊断和治疗的标准指南尚未确立。关于最佳手术入路尚无共识，开胸手术可能是首选的治疗方法。
一名55岁男性最初经胸部计算机断层扫描（CT）初步诊断为侵袭性胸腺瘤，最终经增强胸部CT诊断为左无名静脉瘤。患者无症状。通过正中胸骨切开术进行手术。术中发现一个囊状左无名静脉瘤，未采用血管移植或体外循环（CPB）进行重建，而是用同种异体心包采用连续水平褥式缝合并关闭胸骨切开术进行治疗。手术成功，无重大出血事件；据我们所知，这是首次报道使用同种异体心包连续水平褥式缝合治疗该病症。术后病程及随访情况良好，无需抗凝治疗，1年随访时未观察到复发迹象。
左无名静脉瘤容易被误诊为侵袭性胸腺瘤，可通过增强胸部CT检查或磁共振成像（MRI）明确诊断。这种新方法可能为指导未来的治疗策略提供有价值的见解。
