초록접수 현황
| 19F-059 | 포스터 발표 |
Thoracoscopic Thymothymectomy in Patient with Myasthenia Crisis and Takotsubo Cardiomyopathy
Hee Kyung Kim, Kyung Soo Kim
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
Purpose : Complete thymothymectomy is considered for remission of symptoms in patients with Myasthenia crisis. We present a thoracoscopic approach for the Myasthenia crisis in the older patient with stress-induced (Takotsubo) cardiomyopathy after cardiopulmonary resuscitation.
Methods : A 76-year-old female presented with complaining of sudden swallowing difficulty. She had a history of hypertension and spinal stenosis. During medical evaluation and treatment, respiratory failure develops that cardiopulmonary resuscitation with mechanical ventilation was sustained for 3 weeks. Acetylcholinesterase inhibitors and immunoglobulin was used after diagnosed with Myasthenia gravis crisis with stress-induced cardiomyopathy. A chest CT suggests an about 1.7 x 1.1 cm sized incidental thymic epithelial tumor. Thoracoscopic resection was referred that we performed thoracoscopic surgery, utilizing five, 5 mm ports (3 left-sided, 1 substernal, 1 right-side) for complete thymothymectomy.
Results : Operative time took 190 minutes and estimated blood loss was 30 ml. The pathology results confirmed 1.6 x 1.5 cm sized, WHO type B2 thymic epithelial tumor (T1N0M0) with R0 resection. Postoperative course was uneventful with steroid pulse therapy, and ventilator weaning was achieved on POD#5. She was transferred to general ward on POD#8 and discharged 2 weeks later without showing digestive or respiratory difficulties, and was followed by relapse free for 4 months.
Conclusion : Thoracoscopic surgery can be properly conducted with favorable outcomes in selective cases for Myasthenia gravis crisis with Takotsubo cardiomyopathy.
Methods : A 76-year-old female presented with complaining of sudden swallowing difficulty. She had a history of hypertension and spinal stenosis. During medical evaluation and treatment, respiratory failure develops that cardiopulmonary resuscitation with mechanical ventilation was sustained for 3 weeks. Acetylcholinesterase inhibitors and immunoglobulin was used after diagnosed with Myasthenia gravis crisis with stress-induced cardiomyopathy. A chest CT suggests an about 1.7 x 1.1 cm sized incidental thymic epithelial tumor. Thoracoscopic resection was referred that we performed thoracoscopic surgery, utilizing five, 5 mm ports (3 left-sided, 1 substernal, 1 right-side) for complete thymothymectomy.
Results : Operative time took 190 minutes and estimated blood loss was 30 ml. The pathology results confirmed 1.6 x 1.5 cm sized, WHO type B2 thymic epithelial tumor (T1N0M0) with R0 resection. Postoperative course was uneventful with steroid pulse therapy, and ventilator weaning was achieved on POD#5. She was transferred to general ward on POD#8 and discharged 2 weeks later without showing digestive or respiratory difficulties, and was followed by relapse free for 4 months.
Conclusion : Thoracoscopic surgery can be properly conducted with favorable outcomes in selective cases for Myasthenia gravis crisis with Takotsubo cardiomyopathy.
책임저자: Kyung Soo Kim
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
발표자: Hee Kyung Kim, E-mail : sallykimkr@hanmail.net