Roberts William Clifford, Vowels Travis James, Ko Jong Mi, Capehart John Edward, Hall Shelley Anne
Department of Internal Medicine, (Division of Cardiology), Baylor University Medical Center, Dallas, Texas, USA.
Am J Cardiol. 2009 Jan 1;103(1):110-4. doi: 10.1016/j.amjcard.2008.08.053. Epub 2008 Oct 30.
Three quinquagenarians who underwent insertion of a left ventricular assist device (LVAD) because of severe heart failure and for whom histologic examination of the left ventricular apical "core" (removed to insert the device) showed noncaseating giant cell granulomas typical of sarcoidosis are described. Later, cardiac transplantation showed widespread sarcoid granulomas in the walls of the right and left ventricles and ventricular septum in 2 patients and extensive scarring in the third patient in the absence of coronary narrowing. Previously, 11 patients who underwent cardiac transplantation because of cardiac sarcoidosis had been reported, and in 1 of these patients, diagnosis was also initially made by examination of the left ventricular core excised at the time of insertion of an LVAD. In conclusion, excision of a portion of left ventricular wall to enable insertion of a therapeutic device (LVAD) can also serve as the means of definitive diagnosis of the underlying cardiac condition.
本文描述了三名因严重心力衰竭接受左心室辅助装置（LVAD）植入的五十多岁患者，对其左心室心尖“核心”（为植入装置而切除）进行组织学检查，发现了典型的结节病非干酪样巨细胞肉芽肿。后来，心脏移植显示，两名患者的左右心室壁和室间隔有广泛的结节病肉芽肿，第三名患者在无冠状动脉狭窄的情况下有广泛瘢痕形成。此前，已有11例因心脏结节病接受心脏移植的患者报告，其中1例患者最初也是通过检查LVAD植入时切除的左心室核心作出诊断。总之，切除部分左心室壁以植入治疗装置（LVAD）也可作为确诊潜在心脏疾病的手段。
