Thymoma is one of the most common tumor types in anterior mediastinum, and its surgical treatment according to the type and degree of invasion can be very difficult. A 45-year-old woman with myasthenia gravis underwent a thorax tomography, a finding compatible with thymoma was detected and robotic thymectomy was planned. It was returned to sternotomy because of the presence of severe adhesions. After resection, pericardial patchplasty was performed in the superior vena cava and a graft interposition was made between the left brachiocephalic vein and the right atrium auricular. In this case report, we present a vascular reconstruction alternative in tumor surgery with severe environment and vascular tissue invasion.
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