Lobectomy for a mediastinal basal pulmonary artery

Area of Science:

• Thoracic Surgery
• Vascular Anatomy
• Surgical Oncology

Background:

• Anatomical variations of the pulmonary artery, particularly rare branches like the mediastinal basal pulmonary artery, pose significant risks during pulmonary artery resection.
• These variations can lead to vessel injury and surgical errors, necessitating careful preoperative assessment and intraoperative technique.

Observation:

• A patient with lung cancer presented with a rare mediastinal basal pulmonary artery, identified preoperatively via computed tomography.
• This anomaly represents the earliest branching of the pulmonary artery to the basal segment.

Findings:

• Video-assisted thoracic surgery (VATS) was employed for a right lower lobectomy in a patient with this anatomical variation.
• Meticulous dissection within the lung fissure allowed for the identification and safe management of the mediastinal basal pulmonary artery.
• The right lower lobectomy was successfully completed without complications.

Implications:

• Preoperative identification of mediastinal basal pulmonary artery anomalies is crucial for planning complex thoracic procedures.
• Careful surgical technique, including precise dissection, ensures the safe resection of lung segments in the presence of vascular variations.
• This case highlights the feasibility of VATS for lung cancer surgery even with challenging pulmonary artery anatomy.