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

Dario Amore; Antonio Molino; Umberto Caterino; Carlo Bergaminelli; Dino Casazza; Albina Palma; Pasquale Imitazione; Carlo Curcio

doi:10.1016/j.ijscr.2019.02.014

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

Int J Surg Case Rep. 2019:56:17-19. doi: 10.1016/j.ijscr.2019.02.014. Epub 2019 Feb 19.

Authors

Dario Amore¹, Antonio Molino², Umberto Caterino³, Carlo Bergaminelli⁴, Dino Casazza⁴, Albina Palma⁵, Pasquale Imitazione², Carlo Curcio⁴

Affiliations

¹ Thoracic Surgery Unit, Monaldi Hospital, Naples, Italy. Electronic address: dario.amore@alice.it.
² Department of Respiratory Diseases, Division of Pneumology, University of Naples Federico II, Monaldi Hospital, Naples, Italy.
³ Thoracic Endoscopic Unit, Monaldi Hospital, Naples, Italy.
⁴ Thoracic Surgery Unit, Monaldi Hospital, Naples, Italy.
⁵ Emergency Department, C.T.O., Naples, Italy.

Abstract

Introduction: The anatomical abnormalities in pulmonary veins can have a serious impact on pulmonary resections.

Presentation of case: We report the case of a 70-year-old woman undergoing VATS right upper lobectomy for the treatment of non-small cell lung cancer. During subcarinal dissection, an anomalous vein draining from the superior segment of the right lower lobe into the left atrium and passing behind the bronchus intermedius was incidentally discovered. The patient had, in addition to the inferior pulmonary vein formed by the confluence of superior and common basal veins, a supernumerary vessel identified as: accessory right V⁶. Retrospective review of preoperative enhanced chest computed tomography confirmed the pulmonary vascular anomaly.

Discussion/conclusion: A careful dissection during pulmonary resections can help to recognize variations of the pulmonary veins, avoiding unexpected intraoperative complications.

Keywords: Accessory right V(6); VATS lobectomy; Vascular anomaly.