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Giant Left Atrial Myxoma Prolapsed To Left Ventricule With Every Cardiac Cyclus Operated With Biatrial Transseptal Incision

Year 2015, Volume: 5 Issue: 3, 164 - 167, 11.12.2015

Abstract

Primary cardiac tumors are rarely seen.Most of the intracardiac tumors are benign characterised and mainly seen benign cardiac tumor is myxoma.Our patient was 40 years old woman.She is referring with dyspnea complaint to the Chest Diseases clinic for several times.Echocardiography was performed in Cardiology clinic and a giant left atrial mass(myxoma;5x3 cm diameter) prolapsed to left ventricle through mitral valve with every cardiac cycle was seen.Left ventricle ejection fraction was normal,PABs was 75 mmHg and mild to moderate mitral valve insufficiency was seen.Operation performed with cardiopulmonary bypass and after cross clamping to aorta Dubost’s biatrial transseptal incision done.Myxoma was originated from interatrial septum.Myxoma resected and after resection mitral valve assessed; leaflet coaptation and anotomy were normal.Interatrial septum and atrium was repaired with pericardial patch.Intensive care unit and service follow-up of the patient was normal.Postoperative echocardiography has done and PABs decreased to 35mmHg,mitral valve insufficiency has decreased too. Patient was discharged as healthy.Even though intracardiac tumors are benign characterised; these tumors can cause embolisation, thrombus formation and valve incompetence and etc.Successful results can be obtained in the presence of cardiopulmonary bypass and surgeon should be aware of resecting the tumor completely to prevent recurrence.

References

  • Reynen K, Cardiac Myxomas. N Engl J Med. 1995; 333: 1610-17
  • Reynen K, Frequency of primary tumors of the heart. The American J Card 1996;77(1):107
  • Silverman NA, Primary Cardiac Tumors. Ann Surg. 1980;191(2): 127-138
  • Rengan R, Thomas Jr. CR, Primary Cardiac Tumors. Encyclopeida of Radiation Oncology 2013; pp 647-649
  • Dubost C, Guilmet D, de Parades B, Pedeferri G, New technic of opening of the left auricle in open-heart surgery: the transseptal bi-auricular approach. Press Med 1966; 74: 1607-1608
  • Gavrielatos G, Letsas KP, Pappas LK, Dedeilias P, Sioras E, Kardaras F. Large left atrial myxoma presented as fever of unknown origin: a challenging diagnosis and a review of the literature. Cardiovasc Pathol. 2007; 6: 365-367
  • Akhtar J, Wasay M, Rauf J, Unusual presentation of more common disease/injury Atrial myxoma: a rare cause of cardioembolic stroke. BMJ Case Reports Sep 7 2012; 1-3
  • Lazaros G, Masoura C, Brili S, Stavropoulos G, Kafiri G, Stefanadis C . Large Left Atrial Myxoma in an Oligosymptomatic Young Woman. Hellenic J Cardiol 2013; 54: 60-63

Her Kardiyak Siklusta Mitral Kapaktan Prolabe Olan, Biatriyal Transseptal İnsizyon İle Opere Edilen Dev Sol Atriyal Miksoma

Year 2015, Volume: 5 Issue: 3, 164 - 167, 11.12.2015

Abstract

İntrakardiyak tümörlerin çoğu benign karakterde olup, en sık gözlenen benign kardiyak tümör miksomadır. Benign karakterde olmasına rağmen tedavi edilmediği süreçte mortalite ve morbiditeye etki edecek komplikasyonlara sebebiyet verebilir. 40 yaşında kadın hasta göğüs hastalıkları polikliniğine sık sık nefes darlığı şikayeti ile başvurdu ve çekilen ekokardiyografide sol atriyum içerisinde mitral kapaktan sol ventrikül içerisine prolabe olan 5x3 cm çapında kitle gözlendi. Sol vetrikül sistolik fonksiyonları normal olup, hafif-orta mitral kapak yetmezliği gözlendi ve PABs: 75 mmHg olarak ölçüldü. Preoperatif hazırlıklar sonrası hasta operasyona alındı. Kardiopulmoner bypass’a girilerek, kross klemp konulup cerrahi işleme başlandı. Dubost insizyon kullanılarak kitle eksplore edildi.Kitle interatriyal septuma sapla bağlı olup eksize edildi. Kitle çıkarıldıktan sonra mitral kapak koaptasyonu normal idi ve müdahaleye gerek görülmedi. İnteratriyal septum ve atriotomi perikardiyal yama ile onarıldı. Hastanın yoğun bakım ve servis takip süreci normal olup genel durumu iyi şekilde taburcu edildi.İntrakardiyak kitleler sıklıkla benign karekterde de olsa; emboliye yol açabilmeleri, kapak fonksiyonlarına etki etmeleri, trombüs oluşumuna sebebiyet vermeleri nedeniyle tedavi gerektirmektedir. Kitle tamamen rezeke edilmeli ve rekürrensi engellemek için geride kitleye bağlı doku bırakılmamalıdır. Kardiyopulmoner bypass eşliğinde başarılı sonuçlar alınabilmektedir.

References

  • Reynen K, Cardiac Myxomas. N Engl J Med. 1995; 333: 1610-17
  • Reynen K, Frequency of primary tumors of the heart. The American J Card 1996;77(1):107
  • Silverman NA, Primary Cardiac Tumors. Ann Surg. 1980;191(2): 127-138
  • Rengan R, Thomas Jr. CR, Primary Cardiac Tumors. Encyclopeida of Radiation Oncology 2013; pp 647-649
  • Dubost C, Guilmet D, de Parades B, Pedeferri G, New technic of opening of the left auricle in open-heart surgery: the transseptal bi-auricular approach. Press Med 1966; 74: 1607-1608
  • Gavrielatos G, Letsas KP, Pappas LK, Dedeilias P, Sioras E, Kardaras F. Large left atrial myxoma presented as fever of unknown origin: a challenging diagnosis and a review of the literature. Cardiovasc Pathol. 2007; 6: 365-367
  • Akhtar J, Wasay M, Rauf J, Unusual presentation of more common disease/injury Atrial myxoma: a rare cause of cardioembolic stroke. BMJ Case Reports Sep 7 2012; 1-3
  • Lazaros G, Masoura C, Brili S, Stavropoulos G, Kafiri G, Stefanadis C . Large Left Atrial Myxoma in an Oligosymptomatic Young Woman. Hellenic J Cardiol 2013; 54: 60-63
There are 8 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Hakan Saçlı

Alper Erkin This is me

Bilal Perçin This is me

Mehmet Kırali This is me

Publication Date December 11, 2015
Submission Date December 6, 2015
Published in Issue Year 2015 Volume: 5 Issue: 3

Cite

AMA Saçlı H, Erkin A, Perçin B, Kırali M. Giant Left Atrial Myxoma Prolapsed To Left Ventricule With Every Cardiac Cyclus Operated With Biatrial Transseptal Incision. Sakarya Tıp Dergisi. December 2015;5(3):164-167.

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