右心室外凸一例。

Q4 Medicine

Journal of Cardiology Cases Pub Date : 2025-01-01 DOI:10.1016/j.jccase.2024.09.007

Tsukasa Miyatake MD, PhD , Yuki Tanaka MD , Koji Sato MD, PhD , Noriyuki Otsuka MD, PhD , Akihiko Yotsukura MD, PhD , Noriyoshi Kato MD, PhD , Masayuki Sakurai MD, PhD

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引用次数: 0

摘要

心室外翻，尤其是右心室外翻，是罕见的。在这里，我们报告的情况下，60岁的男性，转介到我们的机构与一个突出的结构在右心室顶点。患者无心脏事件。在计算机断层扫描中偶然发现了外露。该结构通过狭窄的椎弓根与右心室相连。它没有收缩，但表现出运动障碍，壁很薄。我们使用非体外循环冠状动脉旁路装置安全切除了它。组织病理学检查显示仅在结构的底部有肌肉组织，壁的某些部分非常薄。心室外凸的治疗，特别是右心室外凸的治疗是有争议的。如果能积累更多的病例资料，可以通过比较实际破裂风险和手术风险来确定手术适应证。学习目标：心脏心室外袋结构的术语是模糊的，在我们的病人中出现的结构可能被称为憩室、动脉瘤、假性动脉瘤、心外膜囊肿或外袋。一些右心室流出物可以使用非体外循环冠状动脉旁路装置安全切除，而不需要体外循环。右心室外袋手术指征参照左心室外袋手术指征。更多的数据预计将在未来公布。

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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A surgical case of right ventricular outpouching

Outpouching of the heart ventricles, especially of the right ventricle, is rare. Here, we report the case of a 60-year-old male, referred to our institution with an outpouched structure at the right ventricular apex. The patient had no cardiac events. The outpouching was detected incidentally on computed tomography. The structure communicated with the right ventricle through a narrow pedicle. It did not contract, but showed dyskinetic movement with a thin wall. We safely resected it using off-pump coronary bypass apparatuses without cardiopulmonary bypass. Histopathological examination revealed muscular tissues only on the base of the structure, and certain parts of the wall were extremely thin. The treatment of ventricular outpouching, especially of the right ventricle, is controversial. The surgical indications could be decided by comparing the actual risk of rupture with that of surgery if we could accumulate the data from more cases.

Learning objectives

1.
The terminology of heart ventricular outpouched structures is obscure and the structure presented in our patient may be termed a diverticulum, aneurysm, pseudoaneurysm, epicardial cyst, or an outpouching.
2.
Some right ventricular outpouchings can be resected safely using off-pump coronary bypass apparatuses without cardiopulmonary bypass.
3.
The surgical indications for right ventricular outpouching refer to those for left ventricular outpouching. More data are expected in the future.

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