Accessory right V⁶ behind the bronchus intermedius during VATS right upper lobectomy

Area of Science:

• Cardiothoracic Surgery
• Thoracic Oncology
• Anatomical Pathology

Background:

• Anatomical abnormalities of pulmonary veins pose significant risks during pulmonary resection surgeries.
• Variations in pulmonary venous anatomy can lead to unexpected intraoperative complications.

Purpose of the Study:

• To report a case of an incidentally discovered anomalous pulmonary vein during non-small cell lung cancer surgery.
• To highlight the importance of recognizing pulmonary vascular anomalies in thoracic procedures.

Main Methods:

• Case report of a 70-year-old woman undergoing Video-Assisted Thoracoscopic Surgery (VATS) right upper lobectomy.
• Intraoperative identification of a supernumerary vessel (accessory right V6) draining the superior segment of the right lower lobe into the left atrium.
• Preoperative confirmation of the pulmonary vascular anomaly via enhanced chest computed tomography.

Main Results:

• An accessory right V6, a supernumerary pulmonary vein, was identified during subcarinal dissection.
• This anomalous vein drained the superior segment of the right lower lobe and passed posterior to the bronchus intermedius.
• Preoperative imaging confirmed the presence of this rare pulmonary vascular variation.

Conclusions:

• Recognition of pulmonary vein variations is essential for safe pulmonary resections.
• Careful surgical dissection aids in identifying anomalous vessels, thereby preventing intraoperative complications.