Minimally invasive surgery via bilateral thoracotomy for treating left ventricular aneurysm with concomitant ventricular septal rupture.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiothoracic Surgery Pub Date : 2025-02-24 DOI:10.1186/s13019-025-03355-4

Qianzhen Li, Xiaodong Chen, Weiye Xu, Liangwan Chen

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引用次数: 0

Abstract

Background: Full median sternotomy is the traditional approach for the treatment of left ventricular aneurysms (LVA) with or without concomitant ventricular septal rupture (VSR). However, it has some disadvantages such as reduced breathing and exercise thoracic stability, which may increase the surgical risk for older or fragile patients. Herein, we report a case of successful minimally invasive bilateral thoracotomy.

Patient and method: A 79-year-old male patient visited our center complaining of breathlessness and orthopnea 21 days after an acute myocardial infarction and percutaneous coronary intervention. An LVA (34.7 mm × 44.4 mm) and a VSR with a diameter of 10 mm close to the apex was detected by echocardiography. Bilateral thoracotomy was performed via two incisions: a 3 cm incision at the right 3rd intercostal space for the aortic root and left atrium vent cannula and aortic clamping; a 7 cm incision at the left 5th intercostal space to expose the apex for LVA and VSR repair. The patient was discharged 7 days postoperatively without any complications.

Conclusion: LVA with or without VSR can be successfully repaired via bilateral thoracotomy with promising outcomes.

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双侧开胸微创手术治疗左室动脉瘤并发室间隔破裂。

背景：胸骨正中全切开术是治疗伴有或不伴有室间隔破裂的左心室动脉瘤（LVA）的传统方法。然而，它也有一些缺点，如减少呼吸和锻炼胸部稳定性，这可能会增加老年人或虚弱患者的手术风险。在此，我们报告一例成功的微创双侧开胸手术。患者和方法：一名79岁男性患者在急性心肌梗死经皮冠状动脉介入治疗21天后，以呼吸困难和矫形呼吸为主来我中心就诊。超声心动图示1个LVA （34.7 mm × 44.4 mm）和近心尖处直径10 mm的VSR。双侧开胸经2个切口：右侧第3肋间隙3 cm切口用于主动脉根和左心房放空插管并夹持主动脉；在左侧第5肋间隙处开一个7厘米的切口，露出椎尖，用于LVA和VSR修复。术后7天出院，无并发症。结论：有或无VSR的下下腔静脉均可通过双侧开胸手术成功修复，效果良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiothoracic Surgery 医学-心血管系统

CiteScore

2.50

自引率

6.20%

发文量

286

审稿时长

4-8 weeks

期刊介绍： Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.