Omata Motoka, Mitsuboshi Shota, Shidei Hiroaki, Ogihara Akira, Aoshima Hiroe, Isaka Tamami, Hattori Hidetoshi, Nunoda Shinichi, Yamaguchi Junichi, Niinami Hiroshi, Kanzaki Masato
Department of Thoracic Surgery, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo , 162-8666, Japan.
Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
Gen Thorac Cardiovasc Surg Cases. 2025 Jul 9;4(1):30. doi: 10.1186/s44215-025-00213-6.
Survival can be prolonged in patients with end-stage heart failure using left ventricular assist devices (LVADs); however, increased longevity raises the risk of developing noncardiac complications, including malignancies requiring surgery.
A 58-year-old man with an LVAD was referred for the diagnosis and treatment of an undiagnosed nodule in the right upper lobe, which was detected during a preoperative computed tomography (CT) scan, for heart transplantation assessment. CT revealed a 9-mm nodule in the right anterior segment (S), and an 18F-fluorodeoxyglucose positron emission tomography showed significant uptake, suggestive of lung cancer. A robot-assisted thoracoscopic right S segmentectomy was performed. Intraoperative hemodynamic monitoring included an arterial line, a central venous catheter, a pulmonary arterial catheter, and transesophageal echocardiography. The procedure was completed successfully without complications. Pathological analysis confirmed adenocarcinoma, classified as pathological stage T1aN0M0 (Stage IA1). The patient subsequently underwent heart transplantation and LVAD removal on postoperative day 185.
A patient with lung cancer and an LVAD who was awaiting heart transplantation successfully underwent robot-assisted thoracoscopic right S segmentectomy, enabling him to subsequently undergo a heart transplant.
使用左心室辅助装置（LVAD）可延长终末期心力衰竭患者的生存期；然而，寿命延长会增加发生非心脏并发症的风险，包括需要手术治疗的恶性肿瘤。
一名58岁的LVAD患者因术前计算机断层扫描（CT）检查发现右上叶有一个未确诊的结节而被转诊，以进行心脏移植评估。CT显示右前节段（S）有一个9毫米的结节，18F-氟脱氧葡萄糖正电子发射断层扫描显示有明显摄取，提示为肺癌。进行了机器人辅助胸腔镜右S节段切除术。术中血流动力学监测包括动脉置管、中心静脉导管、肺动脉导管和经食管超声心动图。手术顺利完成，无并发症。病理分析证实为腺癌，病理分期为T1aN0M0（IA1期）。患者随后在术后第185天接受了心脏移植并移除了LVAD。
一名等待心脏移植的肺癌合并LVAD患者成功接受了机器人辅助胸腔镜右S节段切除术，随后能够接受心脏移植。
