RESUMO
BACKGROUND AND AIM: We introduced a cardioscopic surgical platform for a wide range of cardiac procedures, to address various intracardiac pathologies, through the left ventricular (LV) apex on the arrested heart. The method involves endoscopic access into the LV cavity; hence the term "transapical cardioscopic surgery (TACS)." METHODS: For this proof-of-concept study, we obtained transapical access to the left ventricle in five pigs. A right minithoracotomy was used for cannulation and cardiopulmonary bypass A purse string-secured incision at the apex allows for introduction of a self-made intracavitary expander, 5 mm steerable-tip endoscopic camera as well as 5 and 3 mm endoscopic instruments. RESULTS: The trans-apical approach provided a good exposure and an adequate surgical field, which allowed us to perform mitral valve repair, mitral valve replacement, and aortic valve replacement. This approach also enabled excellent access and visualization for atrial ablation and intra-aortic procedures. All animals were rewarmed and weaned off bypass. CONCLUSIONS: The proposed transapical cardioscopic platform is feasible for major intra-cardiac procedures.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Endoscopia/métodos , Animais , Valva Aórtica/cirurgia , Ponte Cardiopulmonar , Cateterismo/métodos , Endoscopia/instrumentação , Estudos de Viabilidade , Feminino , Parada Cardíaca Induzida , Implante de Prótese de Valva Cardíaca/métodos , Ventrículos do Coração , Valva Mitral/cirurgia , Modelos Animais , Suínos , Toracotomia/métodosRESUMO
Extramedullary hematopoiesis is a rare condition characterized by the formation of blood cells outside the bone marrow. It is commonly seen in patients with hematopoietic disorders or chronic anemia. Here, we report the case of a 55-year-old patient who had extramedullary hematopoiesis that manifested as an asymptomatic posterior mediastinal mass. Chest computed tomography showed a 30 × 35-mm mass located on the left side of the D11 vertebra. Laboratory investigations revealed no signs of anemia. The tumor was safely and completely removed using video-assisted thoracoscopic surgery. Pathological studies confirmed the extramedullary hematopoiesis nature of the tumor.