AUTHOR=Chen Hong , Mao Yu , Xie Hongtao , Liu Dejun , Zhang Shun , Tian Yongcang , Yang Jian , Bai Benjian 

TITLE=Case report: Cardiac metastatic uterine intravenous leiomyomatosis excision with extracorporeal venous shunt under the guidance of 3-dimensional printing

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1117227

DOI=10.3389/fcvm.2023.1117227

ISSN=2297-055X

ABSTRACT=Intravenous leiomyomatosis (IVL) is relatively rare and the incidence of cardiac IVL is even lower. The case report introduces a 48-year-old woman with two episodes of syncope in the past year. Echocardiography showed a cord-like mass in the inferior vena cava (IVC), right atrium (RA), right ventricle (RV) and pulmonary artery. Computed tomography venography and magnetic resonance imaging showed strips in RA, RV, IVC, right common iliac vein, and internal iliac vein, as well as a round-like mass in the right uterine adnexa. Combined with the patient's prior surgical history and such a rare anatomical structure, surgeons used cardiovascular 3-dimensional (3D) printing technology to create patient-specific preoperative 3D printed model. Surgeons used the 3D printed model to visually and accurately understand the size of IVL and its relationship to adjacent tissues. Finally, we successfully performed a concurrent transabdominal resection of cardiac metastatic IVL and adnexal hysterectomy with off-cardiopulmonary bypass. Preoperative evaluation and guidance of 3D printing may play a critical role in successful surgery for the patient with rare anatomical structures and high surgical risk.