Resection and Reconstruction of a Complex Mediastinal Paraganglioma Involving Major Cardiac Structures

Mediastinal paragangliomas are rare neuroendocrine tumors with a propensity for invading critical cardiovascular structures. We demonstrate our approach for the resection and reconstruction of a mediastinal paraganglioma with extensive cardiac involvement. A 64-year-old man presented with an incidentally discovered 4.5-cm hypervascular mass between the left atrium and right pulmonary artery. After extensive multidisciplinary planning, we performed complete resection using aortic and superior vena cava transection for exposure, with en bloc excision requiring reconstruction of the left atrium, and pulmonary vein using autologous pericardium. With careful preoperative planning, complex cardiac paragangliomas can be managed with complete tumor removal while preserving cardiac function.