RÉSUMÉ
BACKGROUND: Surgical therapy is the most optimal treatment for hepatocellular carcinoma (HCC) combined with bile duct tumor thrombus (BDTT) patients. However, whether to perform bile duct resection (BDR) is still controversial. The purpose of this multicenter research is to compare the effect of BDR on the prognosis of extrahepatic BDTT patients. METHODS: We collected the data of 111 HCC patients combined with extrahepatic BDTT who underwent radical hepatectomy from June 1, 2004 to December 31, 2021. Those patients had either received hepatectomy with extrahepatic bile duct resection (BDR group) or hepatectomy without bile duct resection (NBDR group). Inverse probability of treatment weighting (IPTW) was used to reduce the potential bias between two groups and balance the influence of confounding factors in baseline data. Then compare the prognosis between the two groups of patients. Cox regression model was used for univariate and multivariate analysis to further determine the independent risk factors that influence the prognosis of HCC-BDTT patients. RESULTS: There were 38 patients in the BDR group and 73 patients in the NBDR group. Before and after IPTW, there were no statistical significance in OS, RFS and intraoperative median blood loss between the two groups (all P > 0.05). Before IPTW, the median postoperative hospital stay in the NBDR group was shorter (P = 0.046) and the grade of postoperative complications was lower than BDR group (P = 0.014). After IPTW, there was no difference in postoperative hospital stay between the two groups (P > 0.05). The complication grade in the NBDR group was still lower than that in the BDR group (P = 0.046). The univariate analysis showed that TNM stage and portal vein tumor thrombus (PVTT) were significantly correlated with OS (both P < 0.05). Preoperative AFP level, TNM stage and prognostic nutritional index (PNI) were significantly correlated with postoperative RFS (all P < 0.05). Multivariate analysis showed that tumor TNM stage was an independent risk factor for the OS rate (P = 0.014). TNM stage, PNI and AFP were independent predictors of RFS after radical hepatectomy (all P < 0.05). CONCLUSIONS: For HCC-BDTT patients, hepatocellular carcinoma resection combined with choledochotomy to remove the tumor thrombus may benefit more.
Sujet(s)
Conduits biliaires extrahépatiques , Carcinome hépatocellulaire , Hépatectomie , Tumeurs du foie , Humains , Carcinome hépatocellulaire/chirurgie , Carcinome hépatocellulaire/anatomopathologie , Carcinome hépatocellulaire/mortalité , Carcinome hépatocellulaire/complications , Mâle , Femelle , Tumeurs du foie/chirurgie , Tumeurs du foie/anatomopathologie , Tumeurs du foie/mortalité , Tumeurs du foie/complications , Adulte d'âge moyen , Pronostic , Conduits biliaires extrahépatiques/chirurgie , Conduits biliaires extrahépatiques/anatomopathologie , Thrombose/chirurgie , Thrombose/étiologie , Thrombose/anatomopathologie , Études rétrospectives , Tumeurs des canaux biliaires/chirurgie , Tumeurs des canaux biliaires/anatomopathologie , Tumeurs des canaux biliaires/complications , Tumeurs des canaux biliaires/mortalité , Sujet âgé , AdulteRÉSUMÉ
OBJECTIVE: To summarize the clinical characteristics of patients with renal angiomyolipoma (RAML) combined with inferior vena cava (IVC) tumor thrombus, and to explore the feasibility of partial nephrectomy and thrombectomy in this series of patients. METHODS: The clinical data of patients diagnosed with RAML combined with IVC tumor thrombus in the Department of Urology of the Peking University Third Hospital from April 2014 to March 2023 were retrospectively analyzed, and demographic and perioperative data of RAML patients with IVC tumor thrombus were recorded and collected from Electronic Medical Record System, including age, gender, surgical methods, and follow-up time, etc. The clinical characteristics between classic angiomyolipoma (CAML) patients with IVC tumor thrombus and epithelioid angiomyolipoma (EAML) patients with IVC tumor thrombus were compared to determine the clinical characteristics of these patients. RESULTS: A total of 11 patients were included in this study, including 7 patients with CAML with IVC tumor thrombus and 4 patients with EAML with IVC tumor thrombus. There were 9 females (9/11, 81.8%) and 2 males (2/11, 18.2%), with an average age of (44.0±17.1) years. 9 patients (9/11, 81.8%) experienced clinical symptoms, including local symptoms including abdominal pain, hematuria, abdominal masses, and systemic symptoms including weight loss and fever; 2 patients (2/11, 18.2%) with RAML and IVC tumor thrombus did not show clinical symptoms, which were discovered by physical examination. Among the 11 patients, 10 underwent radical nephrectomy with thrombectomy, of whom, 3 underwent open surgery (3/10, 30.0%), 2 underwent laparoscopic surgery (2/10, 20.0%), and 5 underwent robot-assisted laparoscopic surgery (5/10, 50.0%). In addition, 1 patient underwent open partial nephrectomy and thrombectomy. The patients with EAML combined with IVC tumor thrombus had a higher proportion of systemic clinical symptoms (100% vs. 0%, P=0.003), more intraoperative bleeding [400 (240, 3 050) mL vs. 50 (50, 300) mL, P =0.036], and a higher proportion of tumor necrosis (75% vs. 0%, P=0.024) compared to the patients with CAML combined with IVC tumor thrombus. However, there was no statistically significant difference in operation time [(415.8±201.2) min vs. (226.0±87.3) min, P=0.053] between the two groups. CONCLUSION: Compared with the patients with CAML and IVC tumor thrombus, the patients with EAML and IVC tumor thrombus had a higher rate of systemic symptoms and tumor necrosis. In addition, in the selected patients with CAML with IVC tumor thrombus, partial nephrectomy and tumor thrombectomy could be performed to better preserve renal function.
Sujet(s)
Angiomyolipome , Tumeurs du rein , Néphrectomie , Thrombectomie , Veine cave inférieure , Humains , Angiomyolipome/chirurgie , Angiomyolipome/diagnostic , Angiomyolipome/anatomopathologie , Angiomyolipome/complications , Tumeurs du rein/chirurgie , Tumeurs du rein/anatomopathologie , Tumeurs du rein/diagnostic , Femelle , Mâle , Veine cave inférieure/chirurgie , Veine cave inférieure/anatomopathologie , Études rétrospectives , Néphrectomie/méthodes , Thrombectomie/méthodes , Adulte , Adulte d'âge moyen , Thrombose veineuse/chirurgie , Thrombose veineuse/étiologie , Laparoscopie/méthodes , Thrombose/chirurgie , Thrombose/diagnosticSujet(s)
Tumeurs du rein , Thrombectomie , Humains , Tumeurs du rein/chirurgie , Tumeurs du rein/anatomopathologie , Néphrocarcinome/chirurgie , Néphrocarcinome/anatomopathologie , Thrombose/chirurgie , Thrombose/étiologie , Mâle , Cellules tumorales circulantes/anatomopathologie , Néphrectomie , Tomodensitométrie , Veines rénales/chirurgieRÉSUMÉ
BACKGROUND: Hepatic artery thrombosis is the most common vascular complication of liver transplantation. When occurring late in the postoperative course, it may have no clinical repercussions, and conservative treatment may be implemented. Some patients, however, will develop severe biliary complications due to ischemic cholangiopathy and require retransplantation. The aim of this study is to report the outcomes of retransplantation in this population. METHODS: This is a single-center retrospective study involving all adult patients who underwent liver retransplantation due to late hepatic artery thrombosis from January/2010 to December/2022. RESULTS: During the study period, 1378 liver transplants were performed in our center; 147 were retransplantations, with 13 cases of late hepatic artery thrombosis (0.94%). All had symptomatic ischemic cholangiopathy. Twelve of them had already presented previous cholangitis, bilomas, or liver abscesses and had undergone biliary stenting or percutaneous drainage. The median time between the first liver transplant and late hepatic artery thrombosis diagnosis and between this diagnosis and retransplantation were 73 and 50 days, respectively. Arterial reconstruction using splenic artery, celiac trunk, or arterial conduit from the aorta was performed in 7 cases, whereas biliary reconstruction was mostly done with choledochojejunostomy (n = 8). There were 4 perioperative deaths, 2 due to primary non-function and 2 due to refractory shock after exceedingly complex retransplants. CONCLUSION: Liver retransplantation due to late hepatic artery thrombosis is a rare condition that should be offered to patients who develop severe biliary complications and recurrent infections. It is nonetheless a challenging procedure associated with significant perioperative mortality.
Sujet(s)
Artère hépatique , Transplantation hépatique , Réintervention , Thrombose , Humains , Artère hépatique/chirurgie , Transplantation hépatique/effets indésirables , Thrombose/étiologie , Thrombose/chirurgie , Études rétrospectives , Mâle , Adulte d'âge moyen , Femelle , Adulte , Complications postopératoires/chirurgie , Résultat thérapeutique , Sujet âgéRÉSUMÉ
Most of the cases demonstrating describing acute findings using point-of-care ultrasound (POCUS) have been described in emergency medicine and critical care medicine. While the use of POCUS has become more prevalent in anesthesia practice, documentation of acute findings resulting in alteration in management based on real-time ultrasound findings during pediatric anesthesia remains limited. This case highlights the use of POCUS during cardiopulmonary collapse occurring during correction of neuromuscular scoliosis. POCUS excluded the presumed diagnosis of venous air embolism and identified an intracardiac thrombus leading to the diagnosis and treatment of pulmonary embolism.
Sujet(s)
Systèmes automatisés lit malade , Embolie pulmonaire , Échographie , Humains , Cardiopathies/imagerie diagnostique , Cardiopathies/chirurgie , Embolie pulmonaire/imagerie diagnostique , Scoliose/chirurgie , Scoliose/imagerie diagnostique , Thrombose/imagerie diagnostique , Thrombose/chirurgie , Mâle , EnfantRÉSUMÉ
Intra-cardiac thrombosis is a potentially devastating complication of extracorporeal membrane oxygenation (ECMO) mechanical circulatory support. We present here a patient who suffered complete thrombosis of a fresh mitral prosthesis and left atrium in the setting of ECMO with aortic insufficiency who was treated with repeat valve replacement and thrombectomy. To our knowledge, she is the only patient in the reported literature to have survived this complication.
Sujet(s)
Bioprothèse , Oxygénation extracorporelle sur oxygénateur à membrane , Atrium du coeur , Prothèse valvulaire cardiaque , Valve atrioventriculaire gauche , Thrombose , Femelle , Humains , Bioprothèse/effets indésirables , Oxygénation extracorporelle sur oxygénateur à membrane/méthodes , Prothèse valvulaire cardiaque/effets indésirables , Implantation de valve prothétique cardiaque/effets indésirables , Valve atrioventriculaire gauche/chirurgie , Thrombectomie/méthodes , Thrombose/étiologie , Thrombose/chirurgie , Sujet âgéRÉSUMÉ
Hepatic abscesses are divided into bacterial and amoebic types. Although the prognosis of bacterial liver abscesses has improved owing to progress in drainage techniques and antimicrobial agents, poor outcomes remain common. While there have been some reports of amoebic liver abscesses complicated by thrombosis, bacterial liver abscesses and subsequent thrombus in the right atrium are very rare. We herein report the case of an 82-year-old man. He had suffered acute obstructive suppurative cholangitis 10 months previously, and bile culture yielded Enterococcus faecalis. In the present case, a right atrial thrombus caused by a bacterial liver abscess was observed and the causative organism was thought to be Enterococcus faecalis, for which was detected in a blood culture was positive. The patient was successfully treated with hepatic abscess drainage and surgical right atrial thrombectomy under cardiopulmonary bypass with a beating heart.
Sujet(s)
Atrium du coeur , Cardiopathies , Abcès hépatique à pyogènes , Thrombose , Humains , Mâle , Abcès hépatique à pyogènes/imagerie diagnostique , Abcès hépatique à pyogènes/complications , Abcès hépatique à pyogènes/chirurgie , Sujet âgé de 80 ans ou plus , Atrium du coeur/chirurgie , Thrombose/chirurgie , Thrombose/imagerie diagnostique , Thrombose/complications , Cardiopathies/complications , Cardiopathies/chirurgie , Cardiopathies/imagerie diagnostique , Enterococcus faecalis , Infections bactériennes à Gram positif/complicationsSujet(s)
Tumeurs du rein , Thrombectomie , Humains , Tumeurs du rein/chirurgie , Tumeurs du rein/anatomopathologie , Néphrocarcinome/chirurgie , Néphrocarcinome/anatomopathologie , Cellules tumorales circulantes/anatomopathologie , Thrombose/chirurgie , Thrombose/étiologie , Mâle , Veines rénales/chirurgie , NéphrectomieRÉSUMÉ
CASE: A 71-year-old woman presented with post-traumatic arthritis 11 months after open reduction and internal fixation for a left proximal humerus fracture (PHF) dislocation. After revision to reverse total shoulder arthroplasty (rTSA), the patient's left upper extremity was found to be avascular. An emergent thrombectomy was performed with restoration of arterial flow after removal of an acute-on-chronic axillary artery thrombus. CONCLUSION: Although rare, as rTSA becomes more common for management of PHF, incidence of associated vascular injuries is likely to rise. Screening methods and clinical vigilance in diagnosis are advised for patients with anterior PHF dislocations and arterial injury risk factors.
Sujet(s)
Arthroplastie de l'épaule , Artère axillaire , Fractures de l'épaule , Thrombose , Humains , Femelle , Sujet âgé , Artère axillaire/chirurgie , Artère axillaire/traumatismes , Artère axillaire/imagerie diagnostique , Fractures de l'épaule/chirurgie , Fractures de l'épaule/imagerie diagnostique , Arthroplastie de l'épaule/effets indésirables , Thrombose/étiologie , Thrombose/imagerie diagnostique , Thrombose/chirurgie , Ostéosynthèse interne/effets indésirables , Complications postopératoires/étiologie , Complications postopératoires/imagerie diagnostique , Réduction de fracture ouverte/effets indésirables , RéinterventionRÉSUMÉ
Infective endocarditis (IE) is today a public health problem, as the recent ESC Guidelines have also recalled. Abscesses can be complications of IE and their presence means that the infection is not controlled. We describe the complex case of a 57-year-old patient, presented in ED for fever and oleocranical bursitis, increase of cardiac enymes at blood samples. He was admitted to our Cardiology Unit because TTE showed a floating peduncolated formation in the left ventricle. The susequent TEE documented also the presence of a myocardial abscess, confirmed at cardiac MRI. Blood cultures were positive for MSSA and the man received specific antibiotic therapy. Anticoagulation treatment was started with UFH and then switched to Warfarin, surgical approach of the lesion would have been too dangerous according to Cardiac Surgeons. Serious and sudden neurological complications then followed, leading the patient to brain death in ICU.
Sujet(s)
Abcès , Antibactériens , Échocardiographie transoesophagienne , Endocardite bactérienne , Thrombose , Humains , Adulte d'âge moyen , Mâle , Abcès/microbiologie , Abcès/imagerie diagnostique , Abcès/traitement médicamenteux , Antibactériens/usage thérapeutique , Résultat thérapeutique , Issue fatale , Endocardite bactérienne/microbiologie , Endocardite bactérienne/complications , Endocardite bactérienne/traitement médicamenteux , Endocardite bactérienne/diagnostic , Endocardite bactérienne/imagerie diagnostique , Thrombose/imagerie diagnostique , Thrombose/microbiologie , Thrombose/étiologie , Thrombose/traitement médicamenteux , Thrombose/chirurgie , Infections à staphylocoques/microbiologie , Infections à staphylocoques/traitement médicamenteux , Infections à staphylocoques/imagerie diagnostique , Infections à staphylocoques/complications , Infections à staphylocoques/diagnostic , Anticoagulants/usage thérapeutique , Imagerie par résonance magnétiqueRÉSUMÉ
A 51-year-old male with a complicated medical history presented with shortness of breath. Preoperative workup confirmed the presence of a large atrial mass. However, delayed gadolinium enhancement CMR with long inversion time (TI 600) showed lack of enhancement, which was suggestive of a thrombus. During cardiac magnetic resonance imaging, delayed gadolinium enhancement sequences with long inversion time (TI 600) are commonly used to distinguish between an avascular thrombus versus a vascular tumor.
Sujet(s)
Myxome , Thrombose , Mâle , Humains , Adulte d'âge moyen , Produits de contraste , Gadolinium , Imagerie par résonance magnétique , Atrium du coeur/imagerie diagnostique , Atrium du coeur/chirurgie , Myxome/complications , Myxome/imagerie diagnostique , Myxome/chirurgie , Thrombose/imagerie diagnostique , Thrombose/chirurgieRÉSUMÉ
BACKGROUND: This study aimed to elucidate the methodology and assess the efficacy of the aortic arch inclusion technique using an artificial blood vessel in managing acute type A aortic dissection (ATAAD). METHODS: We conducted a retrospective review of 18 patients (11 males and 7 females, average age: 56.2 ± 8.6 years) diagnosed with ATAAD who underwent total aortic arch replacement (TAAR) using an artificial vascular "inclusion" between June 2020 and October 2022. During the operation, deep hypothermic circulatory arrest (DHCA) and selective antegrade cerebral perfusion (ACP) of the right axillary artery were employed for brain protection. The 'inclusion' total aortic arch replacement and stented elephant trunk (SET) surgery were performed. RESULTS: Four patients underwent the Bentall procedure during the study, with one additional patient requiring coronary artery bypass grafting (CABG) due to significant involvement of the right coronary orifice. Three patients died during postoperative hospitalization. Other notable complications included two cases of postoperative renal failure necessitating continuous renal replacement therapy (CRRT), one case of postoperative double lower limb paraplegia, and one case of cerebral infarction resulting in unilateral impairment of the left upper limb. Eleven patients underwent computed tomography angiography (CTA) examinations of the aorta three months to one-year post-operation. The CTA results revealed thrombosis in the false lumen surrounding the aortic arch stent in seven patients and complete thrombosis of the false lumen around the descending aortic stent in eight patients. One patient had partial thrombosis of the false lumen around the descending aortic stent, and another patient's false lumen in the thoracic and abdominal aorta completely resolved after one year of follow-up. CONCLUSIONS: Incorporating vascular graft in aortic arch replacement simplifies the procedure and yields promising short-term outcomes. It achieves the aim of total arch replacement using a four-branch prosthetic graft. However, extensive sampling and thorough, prolonged follow-up observations are essential to fully evaluate the long-term results.
Sujet(s)
Anévrysme de l'aorte thoracique , , Substituts sanguins , Implantation de prothèses vasculaires , Thrombose , Mâle , Femelle , Humains , Adulte d'âge moyen , Aorte thoracique/chirurgie , Implantation de prothèses vasculaires/méthodes , /chirurgie , Endoprothèses , Aorte abdominale/chirurgie , Paraplégie , Thrombose/chirurgie , Anévrysme de l'aorte thoracique/chirurgie , Résultat thérapeutiqueRÉSUMÉ
BACKGROUND: Approximately 90% of intracardial thrombi originate from the left atrial appendage in non-valvular atrial fibrillation patients. Even with anticoagulant therapy, left atrial appendage thrombus (LAAT) still occurs in 8% of patients. While left atrial appendage closure (LAAC) could be a promising alternative, the current consensus considers LAAT a contraindication to LAAC. However, the feasibility and safety of LAAC in patients with LAAT have yet to be determined. METHODS: This systematic review synthesizes published data to explore the feasibility and safety of LAAC for patients with LAAT. RESULTS: This study included a total of 136 patients with LAATs who underwent successful LAAC. The Amulet Amplatzer device was the most frequently utilized device (48.5%). Among these patients, 77 (56.6%) had absolute contraindications to anticoagulation therapy. Cerebral protection devices were utilized by 47 patients (34.6%). Transesophageal echocardiography (TEE) is the primary imaging technique used during the procedure. Warfarin and novel oral anticoagulants were the main anticoagulant medications used prior to the procedure, while dual antiplatelet therapy was primarily used post-procedure. During a mean follow-up period of 13.2 ± 11.5 months, there was 1 case of fatality, 1 case of stroke, 3 major bleeding events, 3 instances of device-related thrombus, and 8 cases of peri-device leakage. CONCLUSIONS: This review highlights the preliminary effectiveness and safety of the LAAC procedure in patients with persistent LAAT. Future large-scale RCTs with varied LAAT characteristics and LAAC device types are essential for evidence-based decision-making in clinical practice.
Sujet(s)
Anticoagulants , Auricule de l'atrium , Fibrillation auriculaire , , Thrombose , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Anticoagulants/usage thérapeutique , Anticoagulants/effets indésirables , Anticoagulants/administration et posologie , Auricule de l'atrium/imagerie diagnostique , Auricule de l'atrium/physiopathologie , Fibrillation auriculaire/complications , Fibrillation auriculaire/diagnostic , Fibrillation auriculaire/chirurgie , Contre-indications aux médicaments , Échocardiographie transoesophagienne , Cardiopathies/imagerie diagnostique , /effets indésirables , /instrumentation , Appréciation des risques , Facteurs de risque , Dispositif d'occlusion septale , Thrombose/imagerie diagnostique , Thrombose/étiologie , Thrombose/chirurgie , Résultat thérapeutiqueSujet(s)
Procédures endovasculaires , Cardiopathies , Thrombose , Humains , Thrombose/imagerie diagnostique , Thrombose/étiologie , Thrombose/chirurgie , Résultat thérapeutique , Procédures endovasculaires/instrumentation , Cardiopathies/imagerie diagnostique , Cardiopathies/étiologie , Cardiopathies/thérapie , Mâle , Ablation de dispositif , Calculs biliaires/imagerie diagnostique , Calculs biliaires/chirurgie , Calculs biliaires/thérapie , Femelle , Enfant , Thrombectomie/instrumentationSujet(s)
Sténose aortique , Atrium du coeur , Sténose mitrale , Épanchement pleural , Rhumatisme cardiaque , Thrombose , Humains , Sténose mitrale/chirurgie , Sténose mitrale/complications , Sténose mitrale/imagerie diagnostique , Thrombose/imagerie diagnostique , Thrombose/étiologie , Thrombose/chirurgie , Thrombose/complications , Atrium du coeur/imagerie diagnostique , Sténose aortique/chirurgie , Sténose aortique/complications , Sténose aortique/imagerie diagnostique , Rhumatisme cardiaque/complications , Rhumatisme cardiaque/chirurgie , Épanchement pleural/étiologie , Épanchement pleural/imagerie diagnostique , Femelle , Cardiopathies/étiologie , Cardiopathies/complications , Cardiopathies/imagerie diagnostique , Mâle , Adulte d'âge moyenRÉSUMÉ
BACKGROUND: Morphologically, the risk of aortic aneurysm rupture is mainly evaluated based on its type (e.g., fusiform or saccular) and diameter. Based on the finite element analysis, peak wall stress has been identified as a more sensitive and specific predictor of rupture in recent years. Moreover, in finite analysis, the neck of aneurysm is the highest peak wall stress and is associated with the rupture point. CASE PRESENTATION: A saccular aortic aneurysm (84 mm) was incidentally detected during preoperative examination for chronic empyema in a 74-year-old male patient with a history of polycythemia. Aortic arch graft replacement using an open stent was performed. CONCLUSIONS: Morphologically, this case was associated with a very high risk of rupture; nevertheless, it did not rupture. In this case, a mural thrombus (likely formed due to polycythemia) covered the neck of aneurysm that is experiencing the highest peak wall stress and is associated with the rupture point. The mural thrombus decreased peak wall stress and could reduce the risk of rupture even for huge saccular aneurysms. Furthermore, the mural thrombus was fully occupied in aneurysms, such as during coil embolization. Thus, polycythemia could decrease the risk of rupture of huge saccular aneurysms.
Sujet(s)
Anévrysme de l'aorte abdominale , Anévrysme de l'aorte , Rupture aortique , Polyglobulie , Thromboembolie , Thrombose , Mâle , Humains , Sujet âgé , Polyglobulie/complications , Anévrysme de l'aorte/complications , Rupture aortique/complications , Thrombose/complications , Thrombose/chirurgie , Thromboembolie/complications , Anévrysme de l'aorte abdominale/complicationsRÉSUMÉ
A 67 years old male had underwent left upper division segmentectomy. On the sixth day after surgery, he had developed unconsciousness, aphasia and unilateral spatial neglect. Brain MRI revealed a cerebral infarction, and percutaneous cerebral thrombectomy was performed. Enhanced computed tomography revealed thrombus formation in the remnant superior pulmonary vein (SPV), left renal infarction and right acute limb ischemia. After starting anticoagulant therapy with apixaban the thrombus reduced and neurological symptoms improved. A thrombus in the SPV may cause serious whole body organ infarction in the same way as a left atrial thrombus. It was suggested that left upper division segmentectomy was associated with the risk of remnant pulmonary vein thrombosis.
Sujet(s)
Tumeurs du poumon , Veines pulmonaires , Thromboembolie , Thrombose , Humains , Mâle , Sujet âgé , Veines pulmonaires/imagerie diagnostique , Veines pulmonaires/chirurgie , Pneumonectomie/méthodes , Tumeurs du poumon/chirurgie , Thromboembolie/chirurgie , Thrombose/chirurgie , InfarctusRÉSUMÉ
A 74-year-old woman had been on hemodialysis for about 2 months using a short-term indwelling dialysis catheter due to chronic kidney disease. A 20 mm-diameter left atrial neoplastic lesion was noted during a screening echocardiogram performed at the time of induction of hemodialysis. The lesion rapidly increased to 30 mm 2 months later and was referred to our hospital for surgical resection. Under cardiopulmonary bypass and cardiac arrest, tumor resection was performed. Although the lesion was myxomatous with a thin stalk on the left atrial ceiling, the pathological diagnosis was thrombus. After the initiation of anticoagulation, the patient was discharged.