机器人辅助外科手术切除二尖瓣腱索乳头状弹性纤维瘤1例(英文)

Successful removal of a papillary fibroelastoma attached to the mitral valve chordae by robotic assisted surgery One-case report

报道1例罕见的二尖瓣后瓣腱索乳头状弹性纤维瘤患者,该肿瘤导致患者出现一系列症状,如心悸、频发室性早博等。术前心脏超声提示肿瘤位于二尖瓣下,附着于后瓣腱索,合并二尖瓣关闭不全,卵圆孔未闭。传统的心脏外科手术多数经胸部正中切口途径实施,手术创伤较大,且有胸部切口感染的风险。文章报道另一种手术方式,在机器人辅助下,经右胸5cm长切口,在被放大的清晰手术视野下,精细手术切除附着于腱索的肿瘤;并同期顺利实施二尖瓣修补术和未闭卵圆孔缝闭术。术后超声检查未见二尖瓣关闭不全,患者住院时间短,术后顺利恢复。

We presented a rare case of papillary fibroelastoma attached to the mitral chordae of posterior leaflet which caused a serial of symptoms including palpitation and frequent ventricular ectopics. Preoperative echo showed that the tumor was located under the mitral leaflet and attached to the chord of posterior leaflet. It was concomitant with mitral regurgitation and patent foramen ovale. Conventionally, most of the cardiac surgery accessed through median sternotomy. There were relatively large incisions and the risk of deep sternal infection existed. Another operative option was also reported. Under the magnified operative field, the tumor which was attached in the mitral chord was gently removed using robotic assisted surgery approaching through 5 cm right thoractomy. The mitral valve repairment and closure of patent foramen ovale were performed contemporarily. Postoperative echo showed no mitral regurgitation. With relative short hospital stay, the patient recovered from surgery uneventfully.