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为一名患右位心及全内脏反位的孕妇进行再次机器人心脏手术及同期剖宫产术。

Redo robotic cardiac surgery and concomitant cesarean section in a pregnant patient with dextrocardia and situs inversus totalis.

作者信息

Bolcal Cengiz, Kadan Murat, Sicim Hüseyin, Ulubay Mustafa, Yildirim Vedat

机构信息

Department of Cardiovascular Surgery, Gülhane Training and Research Hospital, Health Sciences University, Ankara, Turkey.

Department of Gynecology and Obstetrics, Gülhane Training and Research Hospital, Health Sciences University, Ankara, Turkey.

出版信息

J Card Surg. 2019 Sep;34(9):863-866. doi: 10.1111/jocs.14128. Epub 2019 Jun 24.

Abstract

Reoperations in cardiac surgery are very difficult and risky operations due to possible complications. A 35-week pregnant, 27-year-old woman patient presented to the cardiology department with palpitations. Control transthoracic echocardiography revealed a mass in the right atrium with dimensions of 24 × 25 mm. The patient had dextrocardia and situs inversus totalis, and had undergone a robotic atrial septal defect repair operation 1 year ago. Operation was planned for the patient with the joint decision of cardiology, obstetrics, pediatrics, anesthesia, and cardiovascular surgery departments. Redo robotic heart surgery was performed in beating heart after the operation of the cesarean, and the mass in the right atrium was successfully removed. In conclusion, as it is seen in our case, robotic cardiac surgery can be safely and successfully performed, and can minimize morbidity and mortality even in very complex clinical conditions such as pregnancy, dextrocardia, and reoperation.

摘要

由于可能出现的并发症,心脏外科再次手术是非常困难且具有风险的手术。一名27岁、怀孕35周的女性患者因心悸前往心内科就诊。经胸超声心动图检查发现右心房有一个大小为24×25毫米的肿块。该患者有右位心和全内脏转位,1年前曾接受机器人辅助房间隔缺损修复手术。在心内科、产科、儿科、麻醉科和心血管外科共同决定后,为该患者制定了手术计划。剖宫产术后在心脏跳动的情况下进行了机器人辅助心脏再次手术,成功切除了右心房的肿块。总之,正如我们病例所示,机器人心脏手术即使在怀孕、右位心和再次手术等非常复杂的临床情况下也能安全、成功地进行,并可将发病率和死亡率降至最低。

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