Shibahashi Kohei, Itoh Atsushi, Shintani Yoshiko, Kawase Yushi, Yanagimoto Kunio, Yano Kunio
Department of Cardiovascular Surgery, Yokohama Sakae Kyosai Hospital, Yokohama,Japan.
Kyobu Geka. 2022 Oct;75(11):961-965.
A 76-year-old man was admitted to our hospital for a thorough examination of a suspected cardiac tumor on transthoracic echocardiography. Transesophageal echocardiography demonstrated a 9.4×8.1 mm mobile stalk-like mass in the left ventricular outflow tract. A preoperative electrocardiogram revealed paroxysmal atrial fibrillation. Tumor resection and pulmonary vein isolation were performed to prevent embolism and confirm the diagnosis. The tumor was resected using an endoscope because it was difficult to evaluate the tumor under direct view from the aortic valve. Pathological diagnosis was cardiac papillary fibroelastoma. Postoperative echocardiography showed no residual tumor or aortic regurgitation. One year and eight months passed since the surgery, and no recurrence of the tumor was detected. In cases like this one, where direct observation of the tumor is difficult, we suggest that the use of an endoscope may be effective because it has the advantage of sharing information with other surgeons.
一名76岁男性因经胸超声心动图检查怀疑心脏肿瘤而入院接受全面检查。经食管超声心动图显示左心室流出道有一个9.4×8.1毫米的活动蒂状肿块。术前心电图显示阵发性心房颤动。为预防栓塞并明确诊断,进行了肿瘤切除和肺静脉隔离术。由于从主动脉瓣直视下难以评估肿瘤,遂使用内窥镜切除肿瘤。病理诊断为心脏乳头肌纤维弹性瘤。术后超声心动图显示无残留肿瘤或主动脉瓣反流。手术已过去一年零八个月,未检测到肿瘤复发。在像这样难以直接观察肿瘤的病例中,我们建议使用内窥镜可能有效,因为它具有与其他外科医生共享信息的优势。