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[出血性脑梗死急性期手术切除左心房黏液瘤;病例报告]

[Left atrial myxoma surgically resected in acute phase of hemorrhagic cerebral infarction; report of a case].

作者信息

Yamamoto Shu, Shichijo T, Yamane K, Terasaka K

机构信息

Department of Cardiovascular Surgery, Kure Kyosai Hospital, Kure, Japan.

出版信息

Kyobu Geka. 2007 Mar;60(3):237-41.

Abstract

A 61-year-old man who had been suffered from several episodes of cerebral infarction for 3 years complained of left-sided paresthesia and was pointed out hemorrhagic infarction in the right frontal area of the brain by computed tomography (CT) and magnetic resonance imaging (MRI). The echocardiography showed left atrial mass 9 cm in length attaching to the atrial septum, which was diagnosed as left atrial myxoma causing cerebral embolism. As serial MRI showed frequent episode of cerebral infarction, we performed surgical resection of the cardiac tumor on the 10th day after the onset of the neurological symptom. Anticoagulation during cardiopulmonary bypass was maintained with 1.5 mg/kg of heparin sodium and 80 mg/hour of nafamostat mesilate (FUT). Postoperative course was uneventful without neurological deterioration.

摘要

一名61岁男性,3年来曾多次发生脑梗死,主诉左侧感觉异常,经计算机断层扫描(CT)和磁共振成像(MRI)检查发现右侧额叶区有出血性梗死。超声心动图显示左心房有一长9厘米的肿物附着于房间隔,诊断为左心房黏液瘤导致脑栓塞。由于系列MRI显示脑梗死频繁发作,我们在神经症状出现后第10天对心脏肿瘤进行了手术切除。体外循环期间用1.5毫克/千克肝素钠和80毫克/小时甲磺酸萘莫司他(FUT)维持抗凝。术后过程顺利,无神经功能恶化。

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