巨大右心房黏液瘤切除术:电视胸腔镜技术。

Q4 Medicine
Ignacio Morales-Rey, Ignacio Sanchís, Lorena Mujica, Manuel López-Baamonde, Robert Pruna-Guillen, Manuel Castellà
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引用次数: 0

摘要

一名68岁的男性被诊断患有非常大的右心房肿块,这给他带来了宪政和右侧心力衰竭的症状。超声心动图和磁共振成像显示在舒张期肿瘤块阻塞三尖瓣,提示植入物基部靠近下腔静脉-右心房连接处。采用视频胸腔镜下的气道入路手术切除。采用双颈股静脉插管进行体外循环。行顺行德尔尼多心脏停搏术。完整的肿瘤切除无并发症,良好的暴露和清晰的边缘可视化。术后顺利,于术后第4天出院。病理报告证实了黏液瘤的组织学诊断。这种微创方法对这名身体脆弱、营养不良的心脏恶病质患者几乎没有造成任何手术创伤,没有危及临床结果,并保护他免受传统胸骨切开术和在重症监护室和医院长期住院所带来的潜在严重并发症的影响,从而使他能够迅速恢复功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Giant right atrium myxoma resection: video-assisted thoracoscopic technique.

A 68-year-old man was diagnosed with a very large right atrium mass that gave him symptoms of constitutional and right-sided heart failure. Echocardiography and magnetic resonance imaging showed tricuspid occlusion by the tumoural mass during diastole and suggested an implant base near the inferior vena cava-right atrium junction. A video-assisted thoracoscopic port-access approach was used to remove it surgically. Bicaval jugular and femoral cannulation for cardiopulmonary bypass was implemented. Antegrade del Nido cardioplegia was administered. Complete tumour resection was performed without complications, with excellent exposition and visualization for clean margins. The postoperative period was uneventful, and he was discharged on postoperative day 4. The pathology report confirmed a histologic diagnosis of myxoma. This minimally invasive approach caused hardly any surgical trauma to this fragile, malnourished patient with cardiac cachexia, did not jeopardize the clinical outcomes and protected him from potential serious complications derived from a conventional sternotomy and long stays in the intensive care unit and the hospital, thereby allowing him to recover functional capacity swiftly.

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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
60
期刊介绍: The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.
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