scholarly journals Successful resection of invasive thymoma directly invading the superior vena cava and right atrium with a pulmonary artery tumor embolus

2022 ◽  
Vol 36 (1) ◽  
pp. 46-53
Author(s):  
Akihiro Ike ◽  
Naoko Ose ◽  
Soichiro Funaki ◽  
Masato Minami ◽  
Takayoshi Ueno ◽  
...  
2014 ◽  
Vol 12 (1) ◽  
pp. 6 ◽  
Author(s):  
Yong-Qiang Dong ◽  
Jiang-Shui Liang ◽  
Xiao-Ming Zhang ◽  
Shui-Bo Zhu ◽  
Jia-Hang Xu ◽  
...  

Author(s):  
Elizabeth Mack ◽  
Jakin Jagani ◽  
Alexandrina Untaroiu

The most common surgical procedure used to treat right ventricular heart failure is the Fontan procedure, which connects the superior vena cava and the inferior vena cava directly to the left and right pulmonary arteries bypassing the right atrium. Many studies have been performed to improve the Fontan procedure. Research has been done on a four-way connector that can both passively and actively improve flow characteristics of the junction between the Superior Vena Cava (SVC), Inferior Vena Cava (IVC), Left Pulmonary Artery (LPA) and Right Pulmonary Artery (RPA), using an optimized connector and dual propeller system. However, the configuration of these devices do not specify propeller motor placement and has a stagnation point in the center of the connector. This study focuses on creating a housing for the motor in the center of the connector to reduce the stagnation area and further stabilize the propellers. To do this, we created a program in ANSYS that utilizes the design-of-experiment (DOE) function to minimize power-loss and stagnation points in the connector for a given geometry. First, a CFD model is created to simulate the blood flow inside the connector with different housing geometries. The shape and size of the housing are used as parameters for the DOE process. In this study, an enhanced central composite design technique is used to discretize the design space. The objective functions in the DOE are red blood cell residence time and power loss. It was confirmed that the addition of the housing did decrease the size of the stagnation point. In fact, the housing added in stabilizing the flow through the connector by creating a more defined flow path. Because the flowrates from the IVC and SVC are not the same, the best configuration for the housing was found to be asymmetric along the axis of the pulmonary artery. While this is a continuation of previous studies, the creation of an optimized housing for the motors for the propellers makes implementation of the propeller idea more viable in a real life situation. The added stability of the propellers provided by the housing can also decrease the risk of propeller failure due to rotordynamic instability.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V Ferreira ◽  
I Bravio ◽  
L Moura Branco ◽  
S Ranchordas ◽  
X Duarte ◽  
...  

Abstract Introduction Thymoma is the most common primary neoplasm of the anterior mediastinum. Most invasive thymomas are limited to the pericardium. Only few cases of transcaval extension with intracardiac involvement have been reported. Case report We present the case of a 15-year-old boy with previous history of infectious cerebelitis without neurologic sequelae. He presented with interscapular pain for 6 weeks (not improving with symptomatic therapy) and fever for 3 days. On admission, chest radiograph exhibited an opacification in the right hilum (Figure A). He was discharged with antibiotic prescription for presumptive pneumonia. Due to persistence of complaints he was revaluated after 5 days. Signs of superior vena cava (SVC) syndrome were noted. A computerized tomography showed a large soft tissue mass of the anterior mediastinum, in right antero-lateral topography, measuring 12.5x10x9.5 cm with central calcification and extension to the right lung (Figure B). Transthoracic and transoesophageal echocardiography showed an anterior mass compressing the pulmonary artery branch (PA) and SVC with marginal invasion of the right atrium (RA) (Figure C and D). Cardiac MRI confirmed a large mass of the anterior mediastinum with extension and invasion of the right superior lobe, invasion of the superior vena cava with extension into the RA (Figure E). Transthoracic core-needle biopsy was performed and histopathological diagnosis confirmed an invasive thymoma. The case was discussed at joint cardiothoracic surgery and oncology multidisciplinary meeting and it was agreed to neoadjuvant chemotherapy regimen followed by surgery. Intraoperatively, a large tumor invading the SVC and proximal RA was found, in accordance with the echocardiographic and MRI findings. Due to unforeseen metastatic implants on the adventitia of the main PA and ascending aorta, resection of the tumor was not performed. Palliative decompression of the venous system was performed with interposition of a ringed vascular prosthesis between the left brachiocephalic vein and the right atrial appendage. (Figure F). The patient received postoperative radiotherapy and is asymptomatic without signs of SVC syndrome for 3 months. Discussion and conclusion This report illustrates a rare case of an invasive thymoma with extension to cardiac structures. Multimodality imaging for quality decision-making was imperative in the management and for surgical planning of this case. Transthoracic and transoesophageal echocardiography remain the exams of choice for the diagnosis of intracardiac disease. As demonstrated, a high index of suspicion is needed because clinical symptoms are unspecific and late diagnosis of potentially resectable tumors are associated with a poor prognosis. Abstract P1250 Figure. Multimodality imaging


1962 ◽  
Vol 17 (4) ◽  
pp. 706-708 ◽  
Author(s):  
Skoda Afonso ◽  
George G. Rowe ◽  
Cesar A. Castillo ◽  
Charles W. Crumpton

Intracardiac and intravascular blood temperatures were measured in a group of 17 afebrile patients undergoing cardiac catheterization. Using a cardiac catheter with a thermistor mounted at the tip, measurements were made in the following locations: different levels of the inferior vena cava, the superior vena cava, the renal, hepatic, and internal jugular veins, the right atrium, pulmonary artery and pulmonary artery wedge position, coronary sinus and right ventricle, and the left atrium and pulmonary veins (in subjects with atrial septal defects or patent foramen ovale). Data obtained confirm and extend observations made by other investigators. The blood temperature in the pulmonary artery, pulmonary artery wedge, left atrium, and pulmonary vein were found to be very nearly the same. Furthermore, temperature recordings made in different sites of the inferior vena cava, superior vena cava, right atrium, and pulmonary artery show variations phasic with respiration. The mechanism of these thermal variations is discussed. Submitted on February 5, 1962


2016 ◽  
Vol 2016 (4) ◽  
pp. rjw044
Author(s):  
Ashwad Afzal ◽  
Ivan Wong ◽  
Aleksandr Korniyenko ◽  
Alex Ivanov ◽  
Berhane Worku ◽  
...  

2018 ◽  
Vol 26 (5) ◽  
pp. 1771-1774
Author(s):  
Si-yun Wang ◽  
Liang Xie ◽  
En-tao Liu ◽  
Ji-qin Liao ◽  
Gang Chen ◽  
...  

2020 ◽  
Vol 22 (6) ◽  
pp. 283-285
Author(s):  
Zi-Xian Chen ◽  
Xiao-Rui Xiang ◽  
Rui-Sheng Liu ◽  
Ying Feng ◽  
Jiang Nan ◽  
...  

2019 ◽  
Vol 7 (18) ◽  
pp. 498-498
Author(s):  
Tao Yang ◽  
Ruting Hui ◽  
Qingchen Wu ◽  
Jie Tian ◽  
Huanwen Chen

2010 ◽  
Vol 25 (5) ◽  
pp. 515-517 ◽  
Author(s):  
Weidong Li ◽  
Xin Chen ◽  
Xiayi Lv ◽  
Xiaolong Guo ◽  
Yunhai Yang ◽  
...  

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