Mediastinal Mass and Superior Vena Cava Syndrome

An anterior mediastinal mass is one of the most challenging pathologies an anesthesiologist may face during his or her career. To safely care for these patients, it is imperative to know the relevant anatomy of the mediastinum, understand how mediastinal pathology can compromise a patient’s respiratory and cardiovascular systems, and recognize how to prepare for and quickly treat these potentially life-threatening complications. In this chapter, we will present a case of an anterior mediastinal mass with superior vena cava syndrome. We will discuss the important preoperative testing, preanesthetic considerations, risk stratification, and intraoperative anesthetic management. We will also present a flowchart with potential management strategies to assist in safely caring for the majority of these patients.