Diaphragmatic eventration with paroxysmal supraventricular tachycardia; report of a case

摘要

A 68-year-old man visited our hospital complaining of chest discomfort and palpitation and was hospitalized under the diagnosis of diaphragmatic eventration. The chest X-ray showed an elevated left hemidiaphragm including air bubbles. The chest computed tomography (CT) and magnetic resonance imaging (MRI) showed a very high position of the left hemidiaphragm and displacement of the abdominal organs into the left thoracic cavity. The Holter electrocardiogram showed paroxysmal supraventricular tachycardia. The procedure was performed under video-assisted thoracoscopic surgery with a minithoracotomy (7 cm) in the 8th intercostal space. The left diaphragm appeared loose and reduced in thickness, the diaphragm was incised and longitudinal plication 12cm in diameter was accomplished with a series of U-stitches with Teflon-felt. Furthermore, the suture line was reinforced by prolene mesh. Postoperative course was uneventful, and the chest symptom and arrhythmia were resolved immediately.