Successful Treatment of a Chronic Pulmonary Thromboembolism Associated with Right Atrial Thrombus, Atrial Fibrillation and Tricuspid Insufficiency
10.4326/jjcvs.36.41
- VernacularTitle:右房内血栓を認めた慢性肺動脈血栓塞栓症に対する肺動脈血栓内膜摘除術，右房内血栓摘出術，三尖弁輪縫縮術，メイズ手術の１例
- Author:
Hiroshi Iida
;
Yoshio Sudo
;
Hideo Ukita
;
Masahisa Masuda
;
Nobuyuki Nakajima
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2007;36(1):41-44
- CountryJapan
- Language:Japanese
-
Abstract:
We describe an unusual case of a chronic pulmonary thromboembolism with right atrial thrombus. A 56-year-old man suffering from chronic pulmonary thromboembolism for 5 years complained of increasing dyspnea. Computed tomography revealed massive emboli in bilateral pulmonary arteries and a thrombus in the right atrium. Massive tricuspid regurgitation and atrial fibrillation were also recognized. We performed pulmonary thromboendarterectomy using a Jamieson rigid long miniature sucker with a rounded tip and our original flexible sucker under deep hypothermic circulatory arrest. Right atrial thrombectomy, tricuspid annuloplasty and a Maze procedure were also performed during the cooling, recirculating, and warming period. His postoperative cause was uneventful, and he was able to return to an ordinary lifestyle without acquiring oxygen inhalation. Tricuspid annuloplasty and Maze operation during pulmonary thromboendarterectomy contributed to the maintenance of stable homodynamics during and after surgery.
