Minimally Invasive Pulmonary Fibroelastoma Resection

2019 ◽  
Vol 14 (6) ◽  
pp. 577-580 ◽  
Author(s):  
Joseph R. Nellis ◽  
Charles M. Wojnarski ◽  
Zachary W. Fitch ◽  
Nicholas A. Andersen ◽  
Joseph W. Turek
Keyword(s):  
Minimally Invasive ◽  
Main Pulmonary Artery ◽  
Tumor Resection ◽  
Median Sternotomy ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Postoperative Recovery ◽  
Pulmonary Valve Replacement ◽  
Primary Cardiac Tumor ◽  
The Right

Pulmonary fibroelastomas are a rare primary cardiac tumor with less than 50 cases reported in the literature to date. We performed a minimally invasive valve-sparing tumor resection through a left anterior mini-incision (LAMI). The procedure was performed without cardiac arrest or aortic cross clamp, expediting postoperative recovery and allowing for an uncomplicated discharge on postoperative day 5. LAMI is a safe and reliable alternative to median sternotomy for patients requiring interventions on the right ventricular outflow tract and main pulmonary artery, including pulmonary fibroelastoma resection and pulmonary valve replacement when needed.

Doppler evaluation of physiologic peripheral pulmonic stenosis in newborns

1992 ◽  
Vol 2 (2) ◽  
pp. 179-183
Author(s):  
Deborah M. Friedman ◽  
John Fernandes ◽  
Monika Rutkowski ◽  
Delores Danilowicz
Keyword(s):  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Right Ventricular Outflow Tract ◽  
Left Pulmonary Artery ◽  
Ventricular Outflow Tract ◽  
Pulmonic Stenosis ◽  
Flow Gradients ◽  
Doppler Evaluation ◽  
The Right ◽  
Peripheral Pulmonic Stenosis

AbstractA common systolic ejection murmur of the neonate has been attributed to physiologic peripheral pulmonic stenosis. We investigated this auscultatory finding using duplex pulsed Doppler. Three groups of normal fuliterm neonates less than one week old were studied—10 without murmurs, 10 with grade 1/6 murmurs and nine with at least grade 2/6 murmurs. We measured the anatomical size and peak flow velocities in the main pulmonary artery and left and right branches, the peak velocity in the right ventricular outflow tract, and the bifurcation angle. Flow gradients were calculated as 4 (Vmax)2 Groups were compared by t-tests. A loud peripheral pulmonic stenosis murmur was associated with increased pulmonary artery velocities, with left pulmonary artery velocity the most discriminating variable (1.3 ± 0.29 vs 0.94 ± 0.19 m/s; p ≤ 0.05). Although the peak gradient never exceeded 12 mmHg, there was an increased gradient in the loud murmur group (8.7 ± 2.6 vs 5.7 ± 2.2 mmHg; p ≤ 0.05) which may even be underestimated by the lack of angle correction. The left pulmonary artery diameter was also larger in the loud murmur group, but there were no other anatomic or volumetric flow differences between groups. The soft murmur group could not be separated from normals. We conclude that Doppler techniques can confirm the physiologic basis of peripheral pulmonic stenosis murmurs.

scholarly journals Giant Right Ventricular Outflow Tract Myxoma Mimics Pulmonary Embolism: A Case Report

2021 ◽  
Vol 24 (2) ◽  
pp. E333-E335
Author(s):  
Tomomi Nakajima ◽  
Dung Bui ◽  
Thien Vu ◽  
Dang Nguyen ◽  
Dinh Nguyen
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Main Pulmonary Artery ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Urgent Surgery ◽  
Right Ventricular Myxoma ◽  
Surgical Extraction ◽  
The Right

Right ventricular myxoma is very rare, especially its originating from the right ventricular outflow tract (RVOT) and extending to the main pulmonary artery. Here, we report a case of a giant RVOT myxoma, indistinguishable from pulmonary embolism (PE). Although the myxoma is a candidate for urgent surgery, this case satisfied diagnostic criteria for PE and had no indication for intervention, according to the guideline. The strategy for this mass can be completely different, depending on the diagnosis. Surgical extraction was selected because of atypical clinical course, findings, and nagging debut for neoplasm. Then it made hemodynamic status stable by releasing RVOT obstruction and allowed to reveal the diagnosis as myxoma histopathologically.

scholarly journals Cervicomediastinal tuberculous lymphadenitis

2002 ◽  
Vol 130 (7-8) ◽  
pp. 265-269
Author(s):  
Branislava Ivanovic-Krstic ◽  
Dimitra Kalimanovska-Ostric ◽  
Bosiljka Vujisic-Tesic ◽  
Dragana Jovanovic ◽  
Aleksandar Diklic ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Mass ◽  
Extrapulmonary Tuberculosis ◽  
Main Pulmonary Artery ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Tuberculous Lymphadenitis ◽  
Tissue Mass ◽  
Caseating Granuloma ◽  
The Right

Tuberculous lymphadenitis is an uncommon form of extrapulmonary tuberculosis We report on a case of isolated Cervicomediastinal tuberculous lymphadenitis without parenhimal involvement. A 49-year old woman was hospitalized with a four week history of night sweats and weight loss. Plain chest radiography disclosed mediastinal mass of the right side. Echocardiographic examination revealed a soft tissue mass below the ascending aorta and aortic arch causing moderate narrowing of the right ventricular outflow tract and the main pulmonary artery. Computed tomographic scanning showed soft tissue mass in the middle mediastinum surrouding the great vessels extending posteriorly with moderate compression of trachea. Histological examination of the cervical mass revealed caseating granuloma containing acidalcohol fast bacillus. Antituberculous chemiotherapy was started.

Inflow Venous Occlusion for Intracardiac Resection of an Occluding Right Ventricular Tumor

2016 ◽  
Vol 52 (4) ◽  
pp. 259-264 ◽  
Author(s):  
Deanna Rae Worley ◽  
E. Christopher Orton ◽  
Kevin Thomas Kroner
Keyword(s):  
Right Ventricular ◽  
Heart Surgery ◽  
Cardiopulmonary Arrest ◽  
Circulatory Arrest ◽  
Median Sternotomy ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Venous Occlusion ◽  
Inflow Occlusion ◽  
The Right

ABSTRACT Use of normothermic venous inflow occlusion enabled removal of an intracardiac tumor in a 4 yr old, 27 kg, spayed female Airedale terrier with a history of appendicular osteosarcoma and recent exertional syncope. Inflow venous occlusion via a median sternotomy thoracotomy without hypothermia was used to access the mineralized mass within the right ventricular outflow tract. Duration of circulatory arrest was 70 s for this beating heart surgery. A circumscribed intracardiac chondrosarcoma tumor was marginally resected in this dog, successfully alleviating exertional syncope and restoring a normal echogenic appearance of the right heart. Asymptomatic intracardiac chondrosarcoma recurrence and pulmonary metastasis was detected at 309 days and cardiopulmonary arrest occurred 372 days following intracardiac surgery. Use of inflow occlusion is a viable technique for select intracardiac tumors in dogs with preoperative planning.

True aneurysmal dilatation of a valved bovine jugular vein conduit after right ventricular outflow tract reconstruction: a rare complication

2019 ◽  
Vol 29 (8) ◽  
pp. 1097-1098 ◽  
Author(s):  
Tamer Yoldaş ◽  
Utku A. Örün ◽  
Sercan Tak
Keyword(s):  
Right Ventricular ◽  
Jugular Vein ◽  
Rare Complication ◽  
Main Pulmonary Artery ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Paediatric Population ◽  
Outflow Tract ◽  
Bovine Jugular Vein ◽  
The Right

AbstractValved bovine jugular vein conduit is considered a suitable choice for paediatric population with congenital heart defect requiring right ventricle to main pulmonary artery connection. However, complications related to the use of this device have been reported, with conduit failure occurring mainly as a consequence of stenosis, conduit thrombosis, and valve regurgitation. We present a case of aneurysmal conduit failure of a valved bovine jugular vein conduit used to reconstruct the right ventricular outflow tract.

Interposition Technique for Pulmonary Valve Replacement

2021 ◽  
Vol 12 (3) ◽  
pp. 411-413
Author(s):  
Lok Sinha ◽  
Josue Chery ◽  
Richard A. Jonas ◽  
Pranava Sinha
Keyword(s):  
Pulmonary Artery ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Pulmonary Valve ◽  
Pulmonary Stenosis ◽  
Main Pulmonary Artery ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Pulmonary Valve Replacement ◽  
Coronary Compression

Background: Stented bioprosthesis implant at surgical pulmonary valve replacement (PVR) ideally should be 25 to 27 mm to facilitate future percutaneous PVR. This often requires accommodating 35 to 37 mm diameter sewing ring in the pulmonary position and requires anterior patch augmentation of the right ventricular outflow tract (RVOT). We present a novel “interposition” technique of PVR that allows upsizing the valve without RVOT patch augmentation. Methods: Using standard cardiopulmonary bypass, the main pulmonary artery (MPA) is dissected and transected at an appropriate level. The remnants of pulmonary valve leaflets are excised. The valve stent posts are telescoped into distal MPA, the MPA continuity is restored by end-to-end anastomosis of the proximal and distal MPA, with the interposed prosthetic valve sewing ring in the suture line between the two edges of the MPA with the bulk of the sewing ring extravascular. Result: A total of seven patients (tetralogy of Fallot, three; congenital pulmonary stenosis, four; age range: 15-33 years) underwent the procedure. No patient required RVOT patch augmentation, all patients were extubated in the operating room and were fast-tracked to recovery. Our proposed technique of PVR has the following advantages: accommodate larger size valve, eliminates risk of a paravalvar leak, coronary compression, and anterior tilting of the prosthesis. Conclusion: The valve interposition technique avoids the need for RVOT patch, allows implantation of an adequate sized prosthetic valve, maintains native geometry of the pulmonary artery without the risk of tilting of the prosthesis, and eliminates the risk of paravalvular regurgitation and left coronary compression.

scholarly journals Hemi-Clamshell Approach for Fetal Lung Interstitial Tumor Resection in a Neonate: A Case Report

2021 ◽  
Vol 09 (01) ◽  
pp. e72-e75
Author(s):  
Yasuhiro Kuroda ◽  
Hiroaki Fukuzawa ◽  
Insu Kawahara ◽  
Keiichi Morita
Keyword(s):  
Tumor Resection ◽  
Median Sternotomy ◽  
Fetal Lung ◽  
Postoperative Recovery ◽  
Normal Vaginal Delivery ◽  
Uniform Density ◽  
Operative Field ◽  
Shoulder Dysfunction ◽  
Giant Tumor ◽  
The Right

AbstractFetal lung interstitial tumor (FLIT) is a rare primary lung mass in neonates. Classical incisions, such as posterolateral thoracotomy or median sternotomy, do not provide optimal exposure of the operative field for the resection of pediatric thoracic giant tumors. Herein, we report a rare case of a FLIT in a full-term male neonate, with complete resection achieved using a hemi-clamshell approach, which provided the required visualization of the operative field. The neonate was transferred to our hospital because of mild respiratory distress, which developed 18-hour after normal vaginal delivery. A mass in his right chest, without a midline shift, was observed on chest radiographs. Computed tomography showed a well-circumscribed solid anterior cervicothoracic mass, with a uniform density and no apparent cysts, diagnosed as a primary thoracic giant tumor. Once the patient was clinically stabilized, we proceeded with right upper lobectomy, using a hemi-clamshell approach, full sternotomy, and anterolateral thoracotomy, on postnatal day 22.Histopathologic examination revealed an 8.5 × 6.5 × 4.0 cm solid mass within the right upper lobe, which was diagnosed as a FLIT. His postoperative recovery was uneventful. The patient was followed up for 1 year, with no complaints or symptoms and no postoperative shoulder dysfunction. Gross total resection of primary thoracic giant tumors can be accomplished in neonates with optimal exposure of the chest cavity using a hemi-clamshell approach.

Sign in / Sign up

Export Citation Format

Share Document