Warner Alexander, Sharm Rohan, Arora Vishal, Alkhatib Deya, Kuckelman John, Gallo Dominic, Bailey Caryl
Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA.
Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA.
JACC Case Rep. 2025 Jun 4;30(13):104147. doi: 10.1016/j.jaccas.2025.104147.
Teratomas manifest as anterior mediastinal masses in young adults with excellent prognosis after surgical resection. However, given their mediastinal location, these masses can cause life-threatening complications and require challenging surgical resections.
A 22-year-old man was referred for persistent dyspnea with a mediastinal mass. A venous clot in transit resulted in a right atrial mass and bilateral pulmonary emboli, which prevented initial surgical intervention. The use of novel percutaneous techniques reduced his surgical risk and allowed for safe resection of the mass.
Pulmonary emboli increase perioperative mortality, but there are no definitive guidelines for their management. This case highlights the use of a multidisciplinary team and novel percutaneous therapies for perioperative pulmonary emboli and right atrial mass management.
TAKE-HOME MESSAGES: This case demonstrates the use of percutaneous techniques for perioperative management of a right atrial mass and pulmonary emboli. Percutaneous options should be considered in the setting of an initially prohibitive surgical risk.
畸胎瘤在年轻成年人中表现为前纵隔肿块，手术切除后预后良好。然而，鉴于其纵隔位置，这些肿块可导致危及生命的并发症，并且需要具有挑战性的手术切除。
一名22岁男性因持续性呼吸困难伴纵隔肿块前来就诊。移动性静脉血栓导致右心房肿块和双侧肺栓塞，从而妨碍了最初的手术干预。新型经皮技术的应用降低了他的手术风险，并使得肿块得以安全切除。
肺栓塞会增加围手术期死亡率，但对于其管理尚无明确的指南。本病例突出了多学科团队以及新型经皮治疗方法在围手术期肺栓塞和右心房肿块管理中的应用。
本病例展示了经皮技术在右心房肿块和肺栓塞围手术期管理中的应用。在初始手术风险过高的情况下，应考虑经皮治疗方案。
