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Autogenous pericardial angioplasty for thymic malignancies: a narrative review

Locally advanced thymic tumor usually invades adjacent great vessels, while the optimal treatment strategy for vessels resection and prosthetic replacement is still in controversial. We hereby present our series of patients undergoing autologous pericardial angioplasty for thymic malignancies. For i...

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Autores principales: Gao, Hui-Jiang, Shi, Guo-Dong, Pan, Mao-Jie, Liu, Xiao-Tong, Wei, Yu-Cheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794382/
https://www.ncbi.nlm.nih.gov/pubmed/35118312
http://dx.doi.org/10.21037/med-20-57
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author Gao, Hui-Jiang
Shi, Guo-Dong
Pan, Mao-Jie
Liu, Xiao-Tong
Wei, Yu-Cheng
author_facet Gao, Hui-Jiang
Shi, Guo-Dong
Pan, Mao-Jie
Liu, Xiao-Tong
Wei, Yu-Cheng
author_sort Gao, Hui-Jiang
collection PubMed
description Locally advanced thymic tumor usually invades adjacent great vessels, while the optimal treatment strategy for vessels resection and prosthetic replacement is still in controversial. We hereby present our series of patients undergoing autologous pericardial angioplasty for thymic malignancies. For invasive thymic tumors involving the superior vena cava (SVC), the replacement vessel was prepared by autologous pericardium and placed between the right atrium and distal left innominate vein stump to establish a SVC bypass. Then, the distal right innominate vein and proximal SVC were blocked, and the thymic tumor and involved vessel were completely resected, followed by SVC reconstruction using pericardium. We retrospectively analyzed the clinical characteristics and short-term outcomes of six related patients with autologous pericardial angioplasty. Due to the homologous advantages of autologous pericardial transplantation, those patients didn’t need to receive anticoagulant therapy during the perioperative period, so as to avoid the occurrence of hemorrhage, embolism and other graft-related complications. There were no postoperative long-term thoracic drainage (>7 days), anastomotic bleeding, reconstructed vascular stenosis, embolism or even secondary thoracotomy and other related complications occurred in this case series. The application of autologous pericardium for the replacement of mediastinal great vessels in the surgery of locally advanced thymoma is a safe and effective technique. Compared with former artificial materials, such as polytetrafluoroethylene synthetic prosthesis, autologous pericardial transplantation avoids the occurrence of high risk graft-related complications such as postoperative hemorrhage and vascular stenosis, and its clinical application prospect is worth expecting.
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spelling pubmed-87943822022-02-02 Autogenous pericardial angioplasty for thymic malignancies: a narrative review Gao, Hui-Jiang Shi, Guo-Dong Pan, Mao-Jie Liu, Xiao-Tong Wei, Yu-Cheng Mediastinum Review Article Locally advanced thymic tumor usually invades adjacent great vessels, while the optimal treatment strategy for vessels resection and prosthetic replacement is still in controversial. We hereby present our series of patients undergoing autologous pericardial angioplasty for thymic malignancies. For invasive thymic tumors involving the superior vena cava (SVC), the replacement vessel was prepared by autologous pericardium and placed between the right atrium and distal left innominate vein stump to establish a SVC bypass. Then, the distal right innominate vein and proximal SVC were blocked, and the thymic tumor and involved vessel were completely resected, followed by SVC reconstruction using pericardium. We retrospectively analyzed the clinical characteristics and short-term outcomes of six related patients with autologous pericardial angioplasty. Due to the homologous advantages of autologous pericardial transplantation, those patients didn’t need to receive anticoagulant therapy during the perioperative period, so as to avoid the occurrence of hemorrhage, embolism and other graft-related complications. There were no postoperative long-term thoracic drainage (>7 days), anastomotic bleeding, reconstructed vascular stenosis, embolism or even secondary thoracotomy and other related complications occurred in this case series. The application of autologous pericardium for the replacement of mediastinal great vessels in the surgery of locally advanced thymoma is a safe and effective technique. Compared with former artificial materials, such as polytetrafluoroethylene synthetic prosthesis, autologous pericardial transplantation avoids the occurrence of high risk graft-related complications such as postoperative hemorrhage and vascular stenosis, and its clinical application prospect is worth expecting. AME Publishing Company 2021-03-25 /pmc/articles/PMC8794382/ /pubmed/35118312 http://dx.doi.org/10.21037/med-20-57 Text en 2021 Mediastinum. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Review Article
Gao, Hui-Jiang
Shi, Guo-Dong
Pan, Mao-Jie
Liu, Xiao-Tong
Wei, Yu-Cheng
Autogenous pericardial angioplasty for thymic malignancies: a narrative review
title Autogenous pericardial angioplasty for thymic malignancies: a narrative review
title_full Autogenous pericardial angioplasty for thymic malignancies: a narrative review
title_fullStr Autogenous pericardial angioplasty for thymic malignancies: a narrative review
title_full_unstemmed Autogenous pericardial angioplasty for thymic malignancies: a narrative review
title_short Autogenous pericardial angioplasty for thymic malignancies: a narrative review
title_sort autogenous pericardial angioplasty for thymic malignancies: a narrative review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794382/
https://www.ncbi.nlm.nih.gov/pubmed/35118312
http://dx.doi.org/10.21037/med-20-57
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