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INTRACORONARY CATHETER ASPIRATION CAN BE AN ADEQUATE OPTION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION CAUSED BY LEFT ATRIAL MYXOMA

  • Park, Hyung-Seo (Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine) ;
  • Park, Jae-Hyeong (Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine) ;
  • Jeong, Jin-Ok (Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine)
  • Published : 2009.12.27

Abstract

Cardiac myxomas are the most common benign cardiac tumors and can be associated with systemic embolization including acute myocardial infarction (AMI). The probability of an arterial embolization is closely related to a tumor's villous morphology. In cases of AMI caused by cardiac myxoma, open heart surgery including excision of the coronary artery has been the one of the treatment options for removing the myxoma and embolus from the coronary artery to maintain distal coronary flow. However, preparing for emergent open heart surgery takes a considerable amount of time. Moreover, this time delay can deteriorate the coronary perfusion to the infarcted area and is associated with poor clinical prognosis. So intracoronary catheter aspiration can be an additional option to maintain the distal coronary flow. In this report we present a case with acute anterior ST elevation myocardial infarction caused by a left atrial myxoma. The embolus in the left anterior descending coronary artery was successfully removed with intracoronary catheter aspiration, and distal coronary flow was restored after the procedure.

Keywords

References

  1. Reynen K. Cardiac myxomas. N Engl J Med 1995;333:1610-7. https://doi.org/10.1056/NEJM199512143332407
  2. Kim SE, Park DG. Tentatively diagnosed as myxoma: Transit thrombus entrapped in patent foramen ovale. J Cardiovascular Ultrasound 2007; 15:19-22.
  3. Braun S, Schrotter H, Reynen K, Schwencke C, Strasser RH. Myocardial infarction as complication of left atrial myxoma. Int J Cardiol 2005; 101:115-21. https://doi.org/10.1016/j.ijcard.2004.08.047
  4. Kamata S, Kawada T, Kikuchi K, Miyamoto S, Nishimura K, Endo S, Koyama T, Takei H, Funaki S, Yamate Y. [Clinical analysis of embolism with left atrial myxomas.] Kyobu Geka 1996;49:297-300.
  5. Balk AH, Wagenaar SS, Bruschke AV. Bilateral cardiac myxomas and peripheral myxomas in a patient with recent myocardial infarction. Am J Cardiol 1979;44:767-70. https://doi.org/10.1016/0002-9149(79)90300-X
  6. Ha JW, Kang WC, Chung N, Chang BC, Rim SJ, Kwon JW, Jang Y, Shim WH, Cho SY, Kim SS, Cho SH. Echocardiographic and morphologic characteristics of left atrial myxoma and their relation to systemic embolism. Am J Cardiol 1999;83:1579-82, A8. https://doi.org/10.1016/S0002-9149(99)00156-3
  7. Raymond R, Lynch J, Underwood D, Leatherman J, Razavi M. Myocardial infarction and normal coronary arteriography: a 10 year clinical and risk analysis of 74 patients. J Am Coll Cardiol 1988;11:471-7. https://doi.org/10.1016/0735-1097(88)91519-7
  8. Cheitlin MD, McAllister HA, de Castro CM. Myocardial infarction without atherosclerosis. JAMA 1975;231:951-9. https://doi.org/10.1001/jama.231.9.951
  9. Kim MS, Park JH, Kang SK, Na MH, Lee JH, Choi SW, Jeong JO, Seong IW. Acute ST-segment elevation myocardial infarction due to a huge floating thrombus mimicking a myxoma in the left atrium. J Am Soc Echocardiogr 2009;22:1085. e1-3.
  10. White HD, Chew DP. Acute myocardial infarction. Lancet 2008;372: 570-84. https://doi.org/10.1016/S0140-6736(08)61237-4
  11. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 2003;361:13-20. https://doi.org/10.1016/S0140-6736(03)12113-7
  12. Srinivasan M, Rihal C, Holmes DR, Prasad A. Adjunctive thrombectomy and distal protection in primary percutaneous coronary intervention: impact on microvascular perfusion and outcomes. Circulation 2009;119: 1311-9. https://doi.org/10.1161/CIRCULATIONAHA.108.831453

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