Ricerc@Sapienza

BACKGROUND: Resection of lung cancer infiltrating the aortic arch and/or the subclavian artery can be accomplished in selected patient under CardioPulmonary Bypass (CPB). Direct cross-clamping of the aortic arch and the left subclavian artery without CPB for radical resection of the tumor can be an alternative. Hereby, we present our experience with this technique.METHODS: Between October 2016 and May 2019, 9 patients (5 males, 4 females) underwent radical resection of lung cancer infiltrating the aortic arch (n=5) or the left subclavian artery (n=4) by direct cross-clamping technique.

The surgical treatment of locally advanced mediastinal tumors invading the great vessels and
other nearby structures still represent a tricky question, principally due to the technical complexity of the
resective phase, the contingent need to carry out viable vascular reconstructions and, therefore, the proper
management of pathophysiologic issues. Published large-number series providing oncologic outcomes
of patients who have undergone extended radical surgery for invasive mediastinal masses are just a few.