How to do it - Both atrial resection and superior vena cava replacement insleeve pneumonectomy for advanced lung cancer

Extended sleeve pneumonectomy including removal of the superior vena cava, right atrium and parts of left atrium on cardiopulmonary bypass was success fully performed in a 40-year-old man. The tumour was histologically proven a T4 N1 stage with margins free from tumour. Adjuvant radiochemotherapy was administered postoperatively on an outpatient base. The patient did well f or 7 months then he died from myocardial infarction due to metastatic infil tration of the right coronary artery. Other metastatic deposits were not fo und at autopsy. More data from extended pulmonary resections are required t o demonstrate a benefit. (C) 1999 Elsevier Science B.V. All rights reserved .