BACKGROUND Superior vena cava(SVC)aneurysms are a relatively uncommon disease that has not been widely reported.The conventional surgical approach for treating SVC aneurysms includes open thoracotomy and mid-sternotom...BACKGROUND Superior vena cava(SVC)aneurysms are a relatively uncommon disease that has not been widely reported.The conventional surgical approach for treating SVC aneurysms includes open thoracotomy and mid-sternotomy.However,in this case,the aneurysm could be safely resected by thoracoscopic simultaneous lateral and subxiphoid access methods.CASE SUMMARY A 58-year-old male presented with intermittent chest pain and persistent discomfort in the chest area.A chest computed tomography scan revealed a 6.2 cm aneurysm in the left innominate vein and SVC junction.For surgical resection,simultaneous lateral and subxiphoid access were planned to achieve optimal proximal and distal aneurysm control.The approach site was 1 cm below the xiphoid process,the fifth mid-axillary line and the seventh anterior axillary line on the right side.The aneurysm was resected using a stapler.The patient was discharged on the third day after chest tube removal on the second postoperative day with no particular issues.CONCLUSION Aneurysms located within the mediastinum can be accessed through thoracoscopic approach without open surgery and safely resected using vascular staples.展开更多
目的探讨心内直视术中对永存左上腔静脉(persistent left superior vena cava,PLSVC)的外科处理方法。方法回顾性分析江门市中心医院2007年7月至2019年10月21例先天性心脏病合并PLSVC患者的临床资料,其中合并继发孔型房间隔缺损12例,室...目的探讨心内直视术中对永存左上腔静脉(persistent left superior vena cava,PLSVC)的外科处理方法。方法回顾性分析江门市中心医院2007年7月至2019年10月21例先天性心脏病合并PLSVC患者的临床资料,其中合并继发孔型房间隔缺损12例,室间隔缺损3例,部分型房室间隔缺损2例,法洛四联症2例,房间隔缺损合并部分性肺静脉异位连接2例。术中依据PLSVC回流终点的不同,分别采用术中临时阻断或者插直角静脉引流管的方式保证术野的清晰。心内手术完成后,去除临时阻断保留PLSVC 18例,直接结扎PLSVC 1例,通过外科手术将PLSVC的血流引流入右心房2例。结果全组死亡1例,系PLSVC合并法洛四联症,术后因严重低心排、肾功能不全死亡。其余患者均手术成功治愈出院,出院前所有患者行心脏彩超检查,提示PLSVC回流顺畅,无PLSVC相关合并症发生,心功能改善。术后随诊0.5~9年无异常。结论PLSVC术前漏诊率较高,因此要加强术前的影像学检查,术中探查要细致。对于确诊PLSVC的患者,其处理方式应个体化,手术治疗效果良好。展开更多
文摘BACKGROUND Superior vena cava(SVC)aneurysms are a relatively uncommon disease that has not been widely reported.The conventional surgical approach for treating SVC aneurysms includes open thoracotomy and mid-sternotomy.However,in this case,the aneurysm could be safely resected by thoracoscopic simultaneous lateral and subxiphoid access methods.CASE SUMMARY A 58-year-old male presented with intermittent chest pain and persistent discomfort in the chest area.A chest computed tomography scan revealed a 6.2 cm aneurysm in the left innominate vein and SVC junction.For surgical resection,simultaneous lateral and subxiphoid access were planned to achieve optimal proximal and distal aneurysm control.The approach site was 1 cm below the xiphoid process,the fifth mid-axillary line and the seventh anterior axillary line on the right side.The aneurysm was resected using a stapler.The patient was discharged on the third day after chest tube removal on the second postoperative day with no particular issues.CONCLUSION Aneurysms located within the mediastinum can be accessed through thoracoscopic approach without open surgery and safely resected using vascular staples.
文摘目的探讨心内直视术中对永存左上腔静脉(persistent left superior vena cava,PLSVC)的外科处理方法。方法回顾性分析江门市中心医院2007年7月至2019年10月21例先天性心脏病合并PLSVC患者的临床资料,其中合并继发孔型房间隔缺损12例,室间隔缺损3例,部分型房室间隔缺损2例,法洛四联症2例,房间隔缺损合并部分性肺静脉异位连接2例。术中依据PLSVC回流终点的不同,分别采用术中临时阻断或者插直角静脉引流管的方式保证术野的清晰。心内手术完成后,去除临时阻断保留PLSVC 18例,直接结扎PLSVC 1例,通过外科手术将PLSVC的血流引流入右心房2例。结果全组死亡1例,系PLSVC合并法洛四联症,术后因严重低心排、肾功能不全死亡。其余患者均手术成功治愈出院,出院前所有患者行心脏彩超检查,提示PLSVC回流顺畅,无PLSVC相关合并症发生,心功能改善。术后随诊0.5~9年无异常。结论PLSVC术前漏诊率较高,因此要加强术前的影像学检查,术中探查要细致。对于确诊PLSVC的患者,其处理方式应个体化,手术治疗效果良好。
