Resection of a Giant Middle Mediastinal Tumor Using a Transaortopulmonary Arterial Approach

Surgical approaches for giant middle mediastinal tumors are challenging owing to the surrounding great vessels and vital organs. Here, we report the resection of a giant middle mediastinal tumor with feeding vessels from the coronary artery causing exertional dyspnea. Surgical resection involved a clamshell incision and temporary transection of the ascending aorta and right pulmonary artery under cardiopulmonary bypass to achieve optimal visualization. The tumor, diagnosed as unicentric Castleman disease, was safely excised with good postoperative outcomes. This method-the transaortopulmonary arterial approach-offers a favorable surgical tool for giant mediastinal tumors.