VATS thymectomy in left atrial isomerism

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Myasthenia Gravis Management

Background:

• Thymectomy is a standard treatment for myasthenia gravis (MG) and thymic lesions.
• Video-assisted thoracoscopic surgery (VATS) is increasingly adopted as a minimally invasive standard for thymectomy.
• Anatomical variations can pose challenges during thymectomy.

Purpose of the Study:

• To present a case of thymectomy using a bilateral VATS approach in a patient with non-thymomatous MG and complex left atrial isomerism.
• To highlight the feasibility and safety of minimally invasive thymectomy in patients with anomalous anatomy.

Main Methods:

• A bilateral VATS approach was utilized for thymectomy.
• Careful pre-operative planning considering the patient's unique anatomy was essential.

Main Results:

• The bilateral VATS thymectomy was successfully performed.
• The patient was discharged on postoperative day 2, indicating a safe and effective procedure.
• The procedure demonstrated the viability of VATS in managing complex anatomical variations.

Conclusions:

• Minimally invasive thymectomy, specifically VATS, is a safe and effective alternative to open surgery for patients with myasthenia gravis and complex congenital anomalies.
• Anesthetists and surgeons must be aware of and prepared for potential anatomical challenges, such as altered bronchial and venous anatomy, when performing VATS in these patients.