초록접수 현황
| 17F-239 | 포스터 발표 |
Pulmonary Arterial Intimal Sarcoma with Retrograde Extension
Yeong Soo Kim, Chang Soo Lee, Sun Nam Kim, Seok Mok Jeong, Kyung-Taek Park, Il-Yong Han, Young Chul Yoon, Yang-Haeng Lee, Jin Hong Wi
Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
Purpose : The pulmonary arterial intimal sarcomas (PAIS) are uncommon and grow insidiously in the direction of blood flow into peripheral arteries producing vascular obstruction. Less commonly, they grow in a retrograde manner to involve the pulmonary valve and RVOT.
Methods : The patient, a 78-year-old man with hypertension, diabetes mellitus, was admitted with progressive shortness of breath, weight loss. Transthoracic echocardiography showed two mobile thrombus-like mass (23x11mm, 28x 12mm). One of them protruded into the RVOT. There was a moderate degree of pulmonary insufficiency and stenosis. Chest computed tomography showed mural thrombus in RVOT and pulmonary trunk. On the basis of these findings, the patient was scheduled for surgery. After longitudinal pulmonary arteriotomy, extended proximally to the right ventricle, we could find two mass. Because of the adherent nature of the mass, part of the PA wall and the pulmonic valve were resected with mass. Bioprothesis for pulmonic valve was implanted and pulmonary arteriotomy with right ventriculotomy was closed with a bovine patch.
Results : After the mass was excised, the patient’s condition improved. He experienced no complications and was discharged from the hospital on the 14 days. The final pathology was PAIS. He did not undergo adjuvant chemotherapy, because he and his family did not want further management. At his last examination, ten months after his surgery, the patient did not exhibit any clinical complications, recurrence and metastasis.
Conclusion : Herein, we have reported a very rare case of PAIS with retrograde extension to the pulmonary valve and RVOT and underwent surgery successfully.
Methods : The patient, a 78-year-old man with hypertension, diabetes mellitus, was admitted with progressive shortness of breath, weight loss. Transthoracic echocardiography showed two mobile thrombus-like mass (23x11mm, 28x 12mm). One of them protruded into the RVOT. There was a moderate degree of pulmonary insufficiency and stenosis. Chest computed tomography showed mural thrombus in RVOT and pulmonary trunk. On the basis of these findings, the patient was scheduled for surgery. After longitudinal pulmonary arteriotomy, extended proximally to the right ventricle, we could find two mass. Because of the adherent nature of the mass, part of the PA wall and the pulmonic valve were resected with mass. Bioprothesis for pulmonic valve was implanted and pulmonary arteriotomy with right ventriculotomy was closed with a bovine patch.
Results : After the mass was excised, the patient’s condition improved. He experienced no complications and was discharged from the hospital on the 14 days. The final pathology was PAIS. He did not undergo adjuvant chemotherapy, because he and his family did not want further management. At his last examination, ten months after his surgery, the patient did not exhibit any clinical complications, recurrence and metastasis.
Conclusion : Herein, we have reported a very rare case of PAIS with retrograde extension to the pulmonary valve and RVOT and underwent surgery successfully.
책임저자: Jin Hong Wi
Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
발표자: Jin Hong Wi, E-mail : wiccy@hanmail.net