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巨大漂浮性左房黏液瘤切除术后经食管超声心动图术中测定左心室残余质量

[Determination of residual mass in left ventricle by intraoperative transesophageal echocardiography after a giant and floating left atrial myxoma resection].

作者信息

Kavakli Ali Sait, Kavrut Ozturk Nilgun

机构信息

Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation, Antalya, Turquia.

Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation, Antalya, Turquia.

出版信息

Braz J Anesthesiol. 2018 Sep-Oct;68(5):524-527. doi: 10.1016/j.bjan.2017.10.001. Epub 2017 Dec 21.

Abstract

Atrial myxoma is a benign tumor of the heart that occurs primarily in the left atrium. Floating or large left atrial myxomas frequently cause functional mitral stenosis, may also affect mitral valve structure and flow, and lead to mitral regurgitation. Systemic embolization occurs in around 30% of cases either from tumor fragmentation or complete tumor detachment hence it should be removed as soon as it is detected. Intraoperative transesophageal echocardiography has a vital importance in the surgery. After resection of myxoma, intraoperative transesophageal echocardiography must be performed to rule out residual mass. The case here reported is of a 48-year old female, who presented with giant and floating left atrial myxoma. Residue mass was detected with intraoperative transesophageal echocardiography in the left ventricle after the resection of myxoma. Subsequently, the residue mass was successfully removed. Complete resection must be required to prevent possible complications such as recurrence, embolization in atrial myxomas. Transesophageal echocardiography performed intraoperatively is vital importance to confirm that the myxoma is completely resected.

摘要

心房黏液瘤是一种主要发生于左心房的心脏良性肿瘤。漂浮性或巨大的左心房黏液瘤常导致功能性二尖瓣狭窄,也可能影响二尖瓣结构和血流,并导致二尖瓣反流。约30%的病例会发生全身栓塞,原因是肿瘤碎片脱落或肿瘤完全脱离,因此一旦发现应尽快切除。术中经食管超声心动图在手术中至关重要。黏液瘤切除术后,必须进行术中经食管超声心动图检查以排除残留肿块。本文报道的病例是一名48岁女性,患有巨大的漂浮性左心房黏液瘤。黏液瘤切除术后,术中经食管超声心动图在左心室检测到残留肿块。随后,残留肿块被成功切除。必须进行完整切除以预防心房黏液瘤可能出现的并发症,如复发、栓塞等。术中进行经食管超声心动图检查对于确认黏液瘤已被完全切除至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d37/9678251/e5a06c412c38/gr1.jpg

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