Novel Treatment of an Infiltrating Cardiac Fibrosarcoma
Year: 2014
Type: article
Study design: Case Report
Abstract: Novel Treatment of an Infiltrating Cardiac FibrosarcomaA 38-year-old man was diagnosed with primary cardiac sarcoma involving the central cardiac structures.Echocardiography revealed that a pendular portion of the tumor intermittently obstructed the mitral orifice.Magnetic resonance imaging verified infiltration into the interventricular septum and the posterior wall of the left ventricle.A biopsy report showed moderate-to high-grade fibrosarcoma, and a positron emission tomographic-computed tomographic (PET-CT) scan ruled out metastasis.The patient consented to cardiectomy and to the placement of 2 HeartMate ® II (Thoratec Corporation; Pleasanton, Calif ) continuous-flow ventricular assist devices (VADs).After the heart was excised (Fig. 1), only the posterior walls of both atria remained.A right neoatrium was created with a 38-mm reinforced graft that was attached to a sewing ring, as reported previously. 1 Another sewing ring was attached to the left atrial tissue; both VAD inflow conduits were secured within the sewing rings (Fig. 2).Left and right outflow grafts were anastomosed end-to-end to the aorta and the pulmonary artery, respectively.In this patient, there was no dilated pericardial cavity because of the specific reason for his surgery.We were aware that retaining appropriate pericardial bulk was crucial to the patient's eligibility for future heart transplantation.To meet this goal, we did not use a technique described in 2012 2 ; instead, we positioned the pumps to accommodate the whole left part of the remaining pericardial cavity and used longer outflow grafts (in bend reliefs) to fill the whole pericardial cavity (Fig. 3).Postoperative computed tomography showed the configuration of the artificial heart (Figs. 4 and5).
Source: Texas Heart Institute Journal
Language: English
Topic: Cardiac tumors and thrombi
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2084737120