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巨大心脏血管肉瘤的手术切除及受累右心结构重建:1例报告

Surgical resection of a giant cardiac angiosarcoma and reconstruction of involved right heart structures: A case report.

作者信息

Blindaru Andreea, Vasilescu Alexandru, Danet Andrei, Zimnicaru Oana, Cristu Maximilian, Tudorica Stefan, Borjog Tudor, Patrascu Oana, Badiu Catalin Constantin

机构信息

Department of Cardiovascular Surgery, University Emergency Hospital Bucharest, Bucharest, Romania.

Department of Anesthesiology, University Emergency Hospital Bucharest, Bucharest, Romania.

出版信息

Front Cardiovasc Med. 2023 Mar 1;10:1115962. doi: 10.3389/fcvm.2023.1115962. eCollection 2023.

Abstract

We present the case of a young woman without a medical history who presented with a giant right atrial, transtricuspid, and right ventricular mass and in a severe clinical state. Multimodal imaging raised the suspicion of primary cardiac angiosarcoma. Due to rapid hemodynamic and respiratory deterioration, we were forced to perform surgical removal of the mass with a concomitant reconstruction of the involved right heart structures, only 48 h after presentation. The postoperative course was uneventful, and the patient was discharged from the intensive care unit 2 days later. Radical surgical resection with reconstruction of the resected heart structures was the only possible salvage option for giant angiosarcoma, which led to hemodynamic instability. Followed by chemotherapy, this radical approach may prolong survival.

摘要

我们报告一例无病史的年轻女性病例,该患者表现为巨大的右心房、经三尖瓣及右心室肿物,且处于严重临床状态。多模态成像检查引发了原发性心脏血管肉瘤的怀疑。由于血流动力学和呼吸功能迅速恶化,我们在患者就诊仅48小时后就被迫对肿物进行手术切除,并同时重建受累的右心结构。术后过程顺利,患者于两天后从重症监护病房出院。对于导致血流动力学不稳定的巨大血管肉瘤,根治性手术切除并重建切除的心脏结构是唯一可能的挽救方法。后续进行化疗,这种根治性方法可能延长生存期。

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本文引用的文献

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Outcomes after resection of primary cardiac sarcoma.原发性心脏肉瘤切除术后的结果。
JTCVS Open. 2021 Sep 3;8:384-390. doi: 10.1016/j.xjon.2021.08.038. eCollection 2021 Dec.
2
A case of primary cardiac angiosarcoma with surgical resection and reconstruction.一例原发性心脏血管肉瘤的手术切除与重建病例。
J Cardiol Cases. 2021 Aug 18;25(2):103-105. doi: 10.1016/j.jccase.2021.07.012. eCollection 2022 Feb.
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Cardiac Tumors: Diagnosis, Prognosis, and Treatment.心脏肿瘤:诊断、预后和治疗。
Curr Cardiol Rep. 2020 Oct 10;22(12):169. doi: 10.1007/s11886-020-01420-z.
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