患有持续性心律失常的婴儿心脏横纹肌瘤：肿瘤减瘤术和边缘冷冻消融的作用

Infant Cardiac Rhabdomyoma With Incessant Arrhythmia: Role of Tumor Debulking and Margin Cryoablation.

作者信息

Costello John P, Oh Nicholas, Salim Hammoud Miza, El Yaman Malek, Aziz Peter, Ahmad Munir, Karamlou Tara, Najm Hani K

机构信息

Department of Pediatric and Congenital Heart Surgery, Cleveland Clinic Children's Hospital and Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.

Department of Pediatric Cardiology, Cleveland Clinic Children's Hospital, Cleveland Clinic, Cleveland, Ohio.

出版信息

Ann Thorac Surg Short Rep. 2023 Jun 26;1(4):653-655. doi: 10.1016/j.atssr.2023.06.001. eCollection 2023 Dec.

DOI:10.1016/j.atssr.2023.06.001

PMID:39790650

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11708462/

Abstract

We describe the management of a 4-month-old girl (5.0 kg) who presented with atrial arrhythmias in the setting of cardiac rhabdomyomas. Despite maximal medical therapy and extracorporeal membrane oxygenation support, atrial arrhythmias persisted. Surgical tumor debulking of the atrial mass was undertaken on bypass, and a rim of residual tumor on the right atrial free wall was cryoablated. The patient was weaned off antiarrhythmics and discharged on postoperative day 15 and has been arrhythmia free in 14 months of follow-up. Rhabdomyoma resolution is possible with targeted resection and cryoablation of any remaining tumor at the resection margin.

摘要

我们描述了一名4个月大女童（体重5.0千克）的治疗情况，该女童在患有心脏横纹肌瘤的情况下出现房性心律失常。尽管采取了最大程度的药物治疗和体外膜肺氧合支持，房性心律失常仍持续存在。在体外循环下对心房肿块进行了手术减瘤，并对右心房游离壁上的残留肿瘤边缘进行了冷冻消融。患者在术后第15天停用抗心律失常药物并出院，在14个月的随访中未再出现心律失常。通过对切除边缘任何残留肿瘤进行靶向切除和冷冻消融，横纹肌瘤有可能消退。