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心脏肿瘤切除术联合心房和上腔静脉重建。

Resection of a cardiac tumour with reconstruction of the atria and the superior vena cava.

机构信息

Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Santé, France.

出版信息

Multimed Man Cardiothorac Surg. 2023 Oct 12;2023. doi: 10.1510/mmcts.2023.050.

Abstract

Cardiac tumours are very rare and their complete resection, when feasible, remains the only curative treatment. We present the case of a patient who had aortic stenosis. The routine preoperative workup also identified stenosis in the left anterior descending and right coronary arteries, and most importantly, an invasive tumour at the confluence of the superior vena cava-right atrium-left atrium. After discussion by the heart team, and as is usually done in our department for non-complex right coronary lesions, the stenosis was treated by inserting a stent. The patient was operated on for an aortic valve replacement with a concomitant left internal mammary artery to left anterior descending artery coronary artery bypass graft. In addition, the tumour was completely resected surgically. Reconstruction included a patch for the left atrium, another for the right atrium and a Dacron tube for the superior vena cava. Histological analysis confirmed the complete resection of a cardiac hibernoma. Three months after the surgery, the patient is doing well without any symptoms.

摘要

心脏肿瘤非常罕见,当可行时,完全切除仍然是唯一的治愈方法。我们报告了一例主动脉瓣狭窄患者。常规的术前检查还发现左前降支和右冠状动脉狭窄,最重要的是,上腔静脉-右心房-左心房交汇处有一个侵袭性肿瘤。在心脏团队讨论后,我们按照心脏外科的常规做法,对非复杂的右冠状动脉病变进行支架置入治疗。患者接受了主动脉瓣置换术,同时进行左内乳动脉至前降支冠状动脉旁路移植术。此外,肿瘤也被完全切除。重建包括左心房补片、右心房补片和涤纶管用于上腔静脉。组织学分析证实完全切除了心脏冬眠瘤。手术后 3 个月,患者无症状,恢复良好。

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