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Carmelina Gurrieri, MD, James J. Butz, MD, Toby N

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Presentation on theme: "Carmelina Gurrieri, MD, James J. Butz, MD, Toby N"— Presentation transcript:

1 Resection of Intrathoracic Paraganglioma With and Without Cardiopulmonary Bypass 
Carmelina Gurrieri, MD, James J. Butz, MD, Toby N. Weingarten, MD, Irina Bancos, MD, William F. Young, MD, Stephen D. Cassivi, MD, MS, Sameh M. Said, MD, MB, BCh, Travis J. McKenzie, MD, David W. Barbara, MD, Juraj Sprung, MD, PhD  The Annals of Thoracic Surgery  Volume 105, Issue 4, Pages (April 2018) DOI: /j.athoracsur Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Preoperative plasma and urine catecholamines and metanephrine levels of 16 patients with functional paragangliomas. Values are expressed as standardized scores: measured catecholamine or metanephrine level minus upper limit of normal (UNL [reference]) divided by UNL. The overall maximum concentrations of catecholamines are coming from norepinephrine or its metabolites. The dotted line at 0 indicates upper limit of reference range. All individual measurements are presented. The box-and-whisker plots show 25th and 75th percentiles, with median (middle bar) and mean (diamond). The lowest datum for whiskers is within 1.5 interquartile range of the lower quartile, and the highest datum is within 1.5 interquartile range of the upper quartile. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Mediastinal paraganglioma (PGL) involving the great vessels. (B) Foreground shows the excised PGL (black arrow); in the background is the three-dimensional printing reconstruction with the tumor (white arrow) between the ascending aorta and pulmonary artery. (C) Excised PGL. (D) Excision site. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) Preexcision exposure of extracardiac paraganglioma (PGL [arrow]) at the right atrioventricular groove and involving the right ventricle and right coronary artery. (B) Excision of a 3 × 5-cm PGL at the right atrioventricular groove, with the patient receiving cardiopulmonary bypass therapy. (C) Excised PGL. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Oblique reconstructed contrast medium–enhanced computed tomographic study showing a 10.6 × 8.5 × 9.5-cm right atrial paraganglioma in the atrioventricular groove (arrows) and lying directly anterior to the inferior vena cava. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 (A) Front of excised mediastinal 16 × 12-cm paraganglioma. (B) Back of the paraganglioma; surgical clips indicate abundant vascular supply and hemostatic efforts. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

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