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左心耳动脉瘤的外科治疗以预防潜在后遗症。

Surgical management of an aneurysm of the left atrial appendage to prevent potential sequelae.

作者信息

Nakai Yosuke, Asano Miki, Nomura Norikazu, Mishima Akira

机构信息

Department of Cardiovascular Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

出版信息

Interact Cardiovasc Thorac Surg. 2013 Sep;17(3):586-7. doi: 10.1093/icvts/ivt252. Epub 2013 Jun 5.

Abstract

An aneurysm of the left atrial appendage is an extremely rare anomaly that is commonly associated with supraventricular arrhythmia, compression of the coronary arteries, intracardiac thrombus and pulmonary venous stenosis. This condition may be caused by congenital dysplasia of the musculi pectinati and is usually diagnosed in the second to fourth decades of life. We report the surgical management of an asymptomatic 9-year old girl with this anomaly. She was referred to us because of abnormal chest X-ray findings, and investigation revealed an aneurysm of the left atrial appendage. As this condition may have potentially fatal complications, the aneurysm was completely resected under cardiac arrest with cardiopulmonary bypass to prevent recurrence and thrombus formation. We suggest that resection of an aneurysm of the left atrial appendage under cardiac arrest with cardiopulmonary bypass is a reasonable treatment option to prevent potential complications, particularly in children.

摘要

左心耳动脉瘤是一种极其罕见的异常情况,通常与室上性心律失常、冠状动脉受压、心内血栓形成及肺静脉狭窄相关。这种情况可能由梳状肌先天性发育异常引起,通常在人生的第二个至第四个十年被诊断出来。我们报告了一名9岁无症状女童患有此异常情况的手术治疗过程。她因胸部X线检查结果异常被转诊至我们这里,进一步检查发现了左心耳动脉瘤。由于这种情况可能会有潜在的致命并发症,因此在心脏停搏及体外循环下将动脉瘤完全切除,以防止复发和血栓形成。我们认为,在心脏停搏及体外循环下切除左心耳动脉瘤是预防潜在并发症的合理治疗选择,尤其对于儿童患者。

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