Department of Cardiac Surgery, CIMS Hospital, Ahmedabad, Gujarat, India.
Department of Pathology, CIMS Hospital, Ahmedabad,Gujarat, India.
Braz J Cardiovasc Surg. 2022 May 2;37(2):273-276. doi: 10.21470/1678-9741-2020-0623.
Epicardial cysts are rarer benign tumors than pericardial cysts. There have been few reports on surgical management of epicardial cysts. A 17-year-old normotensive boy presented with chest pain and palpitations, which on evaluation was found to be a mediastinal mass (pericardial cyst). Surgical resection of the cyst via thoracotomy was planned. The cyst was diagnosed as an epicardial cyst intraoperatively. However, due to the epicardial origin of cyst and posterior adhesions, resection was done via midline approach. The base was formed by visceral pericardium and eroding into myocardium of left ventricle, so the resection was concluded with on-pump surgery. In case of erroneous diagnosis or undesirable finding, a safer midline approach with on-pump surgery, as an alternative to minimally invasive approach for complicated epicardial cysts (erosion into ventricle/lying in close proximity to important structures or near to coronary arteries) should be considered.
心外膜囊肿比心包囊肿少见，是良性肿瘤。心外膜囊肿的手术治疗鲜有报道。一名 17 岁血压正常的男孩因胸痛和心悸就诊，经评估发现为纵隔肿块（心包囊肿）。计划通过开胸手术切除囊肿。术中诊断为心外膜囊肿。然而，由于囊肿起源于心外膜并与后方粘连，因此通过中线入路进行了切除。囊肿基底由内脏心包形成，并侵蚀到左心室心肌，因此在体外循环下完成了切除。如果诊断错误或发现不理想，对于复杂的心外膜囊肿（侵蚀心室/靠近重要结构或靠近冠状动脉），应考虑采用体外循环下的中线入路替代微创入路，作为一种更安全的选择。
