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J Thorac Cardiovasc Surg 2005;130:230-231
© 2005 The American Association for Thoracic Surgery

Brief Communication

Thoracoscopic approach to the resection of an azygos vein aneurysm

Thomas D. Person, MD, Christopher B. Komanapalli, MD, Hannan Chaugle, MD, Paul H. Schipper, MD, Mithran S. Sukumar, MD *

Division of Cardiothoracic Surgery, Oregon Health & Sciences University, Portland, Ore.

Received for publication November 5, 2004; accepted for publication November 24, 2004.

* Address for reprints: Mithran S. Sukumar, MD, Oregon Health & Sciences University, Department of Surgery, Division of Cardiothoracic Surgery L353, 3181 SW Sam Jackson Park Rd, Portland OR 97201 (Email: sukumarm@ohsu.edu).

The first 20% of the full text of this article appears below.


Figure 1
Dr Sukumar


Idiopathic azygos vein aneurysms are uncommon. Approximately 30 cases have been reported in the literature to date. 1 Go In many of these cases, the aneurysm was asymptomatic. However, reported symptoms have included mass effect with superior vena caval compression, right main stem bronchus compression, and pulmonary embolism. This case is the first report of presyncopal symptoms as a result of an azygos vein aneurysm.

Clinical Summary

A 61-year-old woman presented to the emergency department with lightheadedness, nausea, and leg weakness. Her past medical history was significant for hypothyroidism, for which she was taking levothyroxine (Synthroid). Her initial evaluation included orthostatic vital signs, which revealed significant orthostatic hypotension. Her chest radiograph was grossly normal, and a computed tomographic scan of the chest revealed a posterior mediastinal mass (Figure 1) that was enhancing. This was believed to be consistent with a mediastinal tumor, and magnetic resonance imaging . . . [Full Text of this Article]






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