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关于三尖瓣的一项罕见且具有挑战性的发现：病例报告、临床思考及实际处理

An uncommon and challenging finding regarding the tricuspid valve: case report, clinical considerations, and practical management.

作者信息

Sciatti Edoardo, Limonta Raul, D'Isa Salvatore, Duino Vincenzo, Senni Michele

机构信息

Cardiology Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy.

School of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy.

出版信息

Eur Heart J Case Rep. 2024 Sep 6;8(9):ytae474. doi: 10.1093/ehjcr/ytae474. eCollection 2024 Sep.

DOI:10.1093/ehjcr/ytae474
PMID:39286732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11404511/
Abstract

BACKGROUND

The differential diagnosis of tricuspid masses remains challenging.

CASE SUMMARY

This case involves the incidental detection of a lesion with a non-solid appearance, exhibiting the characteristic 'finger-in-glove' and 'garland-like' morphology, resembling a blind-ended protrusion of the tricuspid leaflet. This presentation is consistent with a tricuspid valve aneurysm, without significant associated stenosis or regurgitation.

DISCUSSION

Given the lesion's morphological features, the patient's asymptomatic status, and the absence of a precipitating event suggestive of an alternative diagnosis, we concluded that the most likely diagnosis is aseptic tricuspid valve aneurysm. Following a multidisciplinary heart team discussion, surgical intervention was deemed unnecessary.

摘要

背景

三尖瓣肿物的鉴别诊断仍然具有挑战性。

病例摘要

该病例为偶然发现的一个非实性病变，呈现出特征性的“手套指”和“花环样”形态，类似三尖瓣叶的盲端突出。这种表现符合三尖瓣动脉瘤，无明显相关狭窄或反流。

讨论

鉴于病变的形态特征、患者无症状状态以及无提示其他诊断的诱发事件，我们得出最可能的诊断是无菌性三尖瓣动脉瘤。经过多学科心脏团队讨论，认为无需手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/7adec3e988c6/ytae474f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/7dfd209ed74e/ytae474il2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/ae2036fce8b6/ytae474f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/1bba6f584bad/ytae474f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/5f706c4df349/ytae474f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/7adec3e988c6/ytae474f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/7dfd209ed74e/ytae474il2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/ae2036fce8b6/ytae474f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/1bba6f584bad/ytae474f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/5f706c4df349/ytae474f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebe/11404511/7adec3e988c6/ytae474f4.jpg

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本文引用的文献

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An incidental finding of a challenging mitral mass: cardiac surgery or not?二尖瓣肿物这一偶然发现：是否进行心脏手术？
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