- Globally, only about ten cases of the cyst inside the pericardium have been reported in the published literature so far.
- The medical team successfully avoided intensive procedures that would have required stopping the heart and lung functions.
Chennai: A 50-year-old woman from Puducherry became the first patient to be treated for a cyst, a lump, inside the pericardium, the double-layered sac around the heart. The milestone was achieved recently at SRM Global Hospitals, where the medical team successfully performed a keyhole surgery to remove the giant mass – measuring around 8X8X5 cms, occupying the whole of the pericardial cavity, avoiding the need for intensive procedures that usually involve stopping the heart and lung functions. Thanks to this minimally invasive approach, the patient was discharged just a few days after the procedure, marking a swift and remarkable recovery.
The medical team, led by Dr. Sujith Velayudhan Indira, Senior Consultant in Cardiothoracic Surgery, included Dr. Sreenath, Cardiac Anaesthetist, Dr. B. Nembian Raja Rajan, Assistant Consultant in Cardiothoracic Surgery, and Dr. Sindhu V., Consultant in Pulmonology.
In his remarks about this achievement, Dr. P. Sathyanarayanan, President of SRM Group of Companies, highlighted the rarity and significance of the case. “Cysts within the pericardial cavity are extremely uncommon, with only a handful of cases documented globally in medical literature. This underscores the uniqueness of the condition, and the importance of the successful treatment carried out at SRM Global Hospitals. The minimally invasive approach stands out because it has eliminated the need for more invasive procedures, which typically require temporarily halting the functions of the heart and lungs – a high-risk process. This accomplishment not only marks a milestone in the hospital’s medical expertise but also sets a benchmark for treating similar rare conditions with less-invasive techniques, ensuring better outcomes and faster recovery times for patients.”
Sharing the patient’s journey, Dr. Sujith Velayudhan Indira said that the 50-year-old woman from Puducherry had been experiencing a persistent cough and difficulty breathing for several weeks. A scan at a local hospital revealed a large cyst in her chest, pressing against the left atrium of the heart. A detailed CT scan confirmed that the growth was dangerously close to major blood vessels, the left atrium, and pulmonary veins. “After further evaluation at SRM Global Hospitals, we decided on a minimally invasive procedure known as a right-sided mini thoracotomy, which involved making a small 6 cm incision. During the surgery, we discovered that the cyst was even more complex than anticipated. It measured approximately 8x8x5 cm and had completely filled the space around the heart, wrapping around major blood vessels and nestled between critical areas such as the right pulmonary artery and the roof of the left atrium, even extending to the tip of the heart’s left atrial appendage.”
On the treatment approach, he added that to treat the cyst, the team used a procedure called marsupialization. This involved carefully opening the cyst, draining its contents, and stitching its edges to nearby tissue to prevent recurrence. “Remarkably, we avoided using a heart-lung machine, which would have required stopping the patient’s heart and lungs during the operation. The patient recovered well after the surgery. Her recovery was smooth, and she was able to return home just four days after the procedure.”
A biopsy later confirmed that the cyst was benign, likely a bronchogenic cyst, a non-cancerous growth that develops during early life. This case highlights the success of minimally invasive techniques in handling even the most challenging medical conditions.