Ahmad Umad, Prayaga Sastry, Kemp Stephanie, Goswami Nilesh
Baylor Scott & White Hillcrest Hospital, Section of Cardiology and Department of Anesthesiology, 50 Hillcrest Medical Boulevard Suite 303, Waco, TX 76712, USA.
Eur Heart J Case Rep. 2024 Sep 16;8(9):ytae466. doi: 10.1093/ehjcr/ytae466. eCollection 2024 Sep.
Intracardiac masses are historically treated with surgery. As percutaneous technologies continue to evolve, non-surgical techniques for mass removal may become options. We present a case of a woman with a large right atrial mass that was percutaneously removed without surgery.
A 77-year-old woman presents with a 40 mm right atrial mass. The mass was increasing in size, and she preferred to avoid surgical removal. The tumour was removed percutaneously from the femoral vein using a large suction cannula in combination with transection of the stalk using an electrified snare. The case was complicated by a haemopericardium that was treated successfully by injecting a haemostatic matrix into the pericardial space. The pathology returned papillary fibroelastoma.
The TEXAS technique used to remove the right atrial mass in this case is a modification of a previously described technique (SEATTLE procedure). Using this method, we were able to remove a 40 mm tumour from the right atrium without surgery. This is the largest reported intracardiac tumour that has been removed percutaneously. Percutaneous removal of right atrial tumours appears feasible, although this may be limited to smaller tumours based on the results of our case.
心脏内肿块历来采用手术治疗。随着经皮技术不断发展，非手术切除肿块的技术可能会成为选择。我们报告一例女性患者，其右心房有一个大肿块，经皮非手术切除。
一名77岁女性，右心房有一个40毫米的肿块。肿块在增大，她希望避免手术切除。使用大型吸引套管经股静脉经皮切除肿瘤，并用电圈套器切断蒂部。该病例并发心包积血，通过向心包腔注射止血基质成功治疗。病理结果回报为乳头状纤维弹性瘤。
本病例中用于切除右心房肿块的TEXAS技术是对先前描述的技术（SEATTLE手术）的改良。使用这种方法，我们能够在不进行手术的情况下从右心房切除一个40毫米的肿瘤。这是报道的经皮切除的最大心脏内肿瘤。经皮切除右心房肿瘤似乎可行，尽管根据我们病例的结果，这可能仅限于较小的肿瘤。
