Kremer Jamila, Farag Mina, Arif Rawa, Brcic Andreas, Sabashnikov Anton, Schmack Bastian, Popov Aron-Frederik, Karck Matthias, Dohmen Pascal M, Ruhparwar Arjang, Weymann Alexander
Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany.
Med Sci Monit Basic Res. 2016 Nov 2;22:128-131. doi: 10.12659/msmbr.901526.
BACKGROUND Total artificial heart (TAH) implantation in patients with aggressive tumor infiltration of the heart can be challenging. CASE REPORT We report on a patient with a rare primary undifferentiated high-grade spindle cell sarcoma of the mitral valve and in the left atrium, first diagnosed in 2014. The referring center did a first resection in 2014. In the course of 17 months, computer tomography (CT) scan again showed massive invasion of the mitral valve and left atrium. Partial resection and mitral valve replacement was not an option. We did a subtotal heart excision with total artificial heart implantation. In this report we discuss complications, risk factors, and perioperative management of this patient. CONCLUSIONS Patients with aggressive tumors of the heart can be considered for TAH implantation.
背景 对于心脏受到侵袭性肿瘤浸润的患者,植入全人工心脏(TAH)可能具有挑战性。病例报告 我们报告了一名患者,其患有罕见的二尖瓣和左心房原发性未分化高级别梭形细胞肉瘤,于2014年首次确诊。转诊中心在2014年进行了首次切除。在17个月的病程中,计算机断层扫描(CT)再次显示二尖瓣和左心房受到大量侵袭。部分切除和二尖瓣置换不是可行的选择。我们进行了心脏次全切除并植入全人工心脏。在本报告中,我们讨论了该患者的并发症、危险因素和围手术期管理。结论 对于患有侵袭性心脏肿瘤的患者,可以考虑植入TAH。