• Title/Summary/Keyword: Left atrium

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Surgical Treatment of Intracardiac Myxoma (심장 점액종의 외과적 치료)

  • 이선희
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1158-1167
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    • 1990
  • Since November 1979, 20 patients have undergone excision of an intracardiac myxoma, which was located in the left atrium in 18[90%], in the right atrium in 1[5%], and in the right ventricle in 1[5%], There were 17 female and 3 male patients with a mean age of 43.5 years [range 23 to 68 years]. Only one patient was asymptomatic, the others were seen mostly exertional dyspnea, palpitation, sings of systemic illness. Diagnosis was confirmed by echocardiography in all cases and angiography in two cases, preoperatively, The myxomas were successfully removed in all patients, either by shaving them from the atrial septum or by excising a portion of normal atrial septum with tumor. All heart chambers were carefully explored for presence of multi-centric myxoma or tumor debris. We conclude that excision of intracardiac myxoma is curative and long term survival is excellent and long term clinical and echocardiographic follow-up are recommended since late recurrence, although rare, has been reported.

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Intraventricular Cavernous Malformation Radiologically Mimicking Meningioma

  • Jin, Sung-Chul;Ahn, Jae-Sung;Kwun, Byung-Duk;Kwon, Do-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.44 no.5
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    • pp.345-347
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    • 2008
  • We report a case of trigonal cavernous malformation (CM) radiologically mimicking meningioma. The computed tomographic (CT) head angiography and magnetic resonance imaging (MRI) showed a partially calcified lesion with slight contrast enhancement located in the area of the left atrium of lateral ventricle. The lesion was completely removed using microsurgery with a parieto-occipital transcortical approach. The resected mass was histologically confirmed as CM. CM should be considered as differential diagnosis in case of the atrial mass lesion due to lack of hemosiderin ring characteristically seen other seated CM.

Surgical Repair of Partial Atrioventricular Canal Defect (부분심내막상 결손증의 교정수술치험 3례)

  • Kim, Yeong-Ho;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.299-304
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    • 1985
  • The partial A-V canal defect consist of ostium primum type atrial septal defect with a cleft mitral anterior leaflet. The clinical findings depend upon the site and size of the left-to-right shunt, the degree of A-V valvular regurgitation, and the degree of resultant pulmonary artery hypertension. We experienced 3 cases of similar condition. The data were as follow: 1. Chest P-A showed increased pulmonary vascularity and moderate cardiomegaly with left atrial enlargement. 2. E.K.G. showed left axis deviation, left atrial enlargement, and left ventricular hypertrophy. 3. Right heart catheterization showed significant 02 step up of SVC-RA and left-to-right shunt. 4. Left ventriculogram showed mitral regurgitation and filling of both atrium. Operative findings were as follow: 1. Primum type atrial septal defect [2x2 cm]. 2. Cleft in the anterior leaflet of the mitral vave. 3. No evidence of ventricular septal defect and tricuspid anomaly. Through a right atriotomy with moderate hypothermia, the mitral cleft was approximated with interrupted sutures. The interatrial communication was closed by a patch of Dacron/pericardium. The patch was attached to junction of the mitral and tricuspid valves along the crest of the ventricular septum using interrupted sutures and the other site using continuous sutures. Postoperative course was uneventful and discharged in good general condition except postoperative bleeding in case 3.

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A Case of Left Atrial Myxoma (좌심방 점액종 1례 보고)

  • 유수웅
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.348-354
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    • 1978
  • Myxoma constitue about 50% of a II primary cardiac, tumor (incidence 0.03%) and occur in any of the cardiac chambers, but about 75% of themare found in the left atrium. As is well known, left atrial myxoma usually simulates mitral valvular disease, and it tends to bring about postural syncope and frequent embolic manifestaticns. The clinical manifestation of left atrial myxoma upon the circulation are obstructive effects, embolic effects and constitutional effects. Diagnosis is now most of all important since surgery can be dramatically curable, whereas untreated myxoma apparently invariably lead to deadful course. Preaprative diagncsis by echocardiogram is so simple and accurate for detection of myxoma that awareness of mitral valvular heart disease with rapid deterioration must be screened. We have diagnosed one case of the left atrial myxoma preopratively by phonocardiogram, echocardiogram and levophase pulmonary angiograJ;n and successfully treated by operation under extra corporeal circulation. A 38 years old housewife was admitted to the National Medical Center because of dyspnea, and paroxysmal cough on occasions for prior to hospitalization. Operation was carried out by median sternotomy and left atriotomy with mild hypothermia under E.C.C. The left atrial myxoma was extirpated including endocardial fragment and its weight was 23gm. The hospital course was not eventful and she can work nowadays without symptoms.

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Treatment of Acute Pulmonary Thromboembolism with Left Atrial Thrombus via Atrial Septal Defect - A case report- (심방중격결손을 통해 좌심방으로 유입되어 있는 혈전을 동반한 급성 폐동맥 혈전색전증의 치험)

  • 김시욱;최재성;유재현;임승평;이영;나명훈
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1010-1014
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    • 2004
  • Though acute pulmonary thromboembolism is usually managed medically with the use of thrombolytics or anticoagulants, an emergent life-saving surgery would be required. In a case of acute pulmonary thromboembolism with acute severe right heart failure and deferment of it could result in fatal outcomes in a short time. In addition, the mortality is raised considerably if it is combined with right heart thrombi. Despite paradoxical thromboembolism via patent foramen ovale was reported, few report might be presented, in which showed the thrombus in right atrium has traversed atrial septal defect into left atrium and left ventricle like this case as the evidence of paradoxical thromboembolism. We report a case of acute pulmonary thromboembolism with acute right heart failure arising from deep vein thrombosis, developed immediately after low anterior resection for colon cancer in a 63-year-old male, who was managed successfully by emergent thromboembolectomy with cardiopulmonary bypass.

A Case of Exceptionally Rapid Growing Cardiac Myxoma (비정상적으로 급속 성장한 심장점액종 1예)

  • Bae, June-Ho;Choi, Jae-Woong;Hong, Geu-Ru;Ryu, Sung-Kee;Park, Ji-Young;Jung, Yu-Min;Lee, Jae-Hoon;Choi, Seung-Kyu
    • Journal of Yeungnam Medical Science
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    • v.27 no.2
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    • pp.155-158
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    • 2010
  • Myxoma is the most common type of primary cardiac tumor and about 75% of myxomas occur in the left atrium of the heart. Most myxomas are diagnosed by echocardiography. The growth rate of myxoma is clearly unknown and newly developed myxoma is difficult to understand clearly the onset of growth. We describe the case of a newly developed huge left atrial myxoma($7{\times}7cm$)which showed no echocardiographic evidence of the tumor four years ago. Four years later the patient underwent transthoracic echocardiography due to preoperative evaluation that was normal. Nine months later, she presented with dyspnea. Transthoracic echocardiography showed a large mass located in left atrium. Pathology showed a myxoma that measured $7{\times}7cm$ implying a growth rate of $0.15{\times}0.15cm/month$.

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A Clinical Evaluatuin on Open Heart Surgery of Congenital and Acquired Heart Disease (선천성 및 후천성 심질환의 개심술)

  • 김근호
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.33-42
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    • 1979
  • The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

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Left Atrial Rupture with Stable Vital Signs - A case report - (정상인 활력증후를 보인 좌심방 파열 - 1예 보고 -)

  • Jeong, Jae-Han;Cho, Sung-Woo;Shin, Yoon-Cheol;Lee, Hee-Sung;Kim, Kun-Il
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.633-635
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    • 2008
  • Cardiac rupture after blunt chest trauma is a relatively uncommon diagnosis, and it is associated with a very high mortality rate. A 41-years-old man crashed his car into a guardrail and he was then transported to hospital. Although unstable vital signs are the most common symptoms of cardiac injury, this patient had stable vital signs. The chest CT scan showed pericardial effusion, and echocardiography did not clearly reveal cardiac tamponade, but the right atrium was slightly collapsed. Cardiac injury was suspected, and surgery was commenced for obtaining the diagnosis and treatment. A 2cm laceration at the junction of the left atrium and the lefl inferior pulmonary vein was discovered and this was repaired with $4{\sim}0$ Polypropylne monofilament sutures. We report here on the successful management of a patient with left atrial rupture following blunt chest trauma.

Clinical Experience of Cardiac Myxoma (심장점액종의 임상적 경험)

  • 김종원;전상협
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.311-314
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    • 1996
  • Eighteen patients (13 female and ave male) aged from 15 to 62 years (mean age 42.6 years) underwent excision of cardiac myxoma(17 left atrial, one right atrial) between 1985 and 1994 at Pusan National University hospital. All patients complained of exertional dyspnea and most had a few additional symtoms including palpitation, chest pain, syncope, general weakness, weight loss, fever, cough and epigastric disconyort. The diagnosis was made by echocardiography alone in left atrial myxomas but a myxoma in right atrium was diagnosed incidentally during mitral valve replacement for rheumatic valvular heart disease. The tumor attachment sites were fossa ovalis in 13, other interatrial septum in 4, mitral valve annulus in one and free wall of left atrium in two cases. The tumor was excised successfully via right atriotomy in 8 and biatriotomy in 10 cases. There was no hospital nor late death, and no recurrent case during the follow up period. Curative surgical excision of cardiac myxoma can be performed with low morbidity and very low r currence rate.

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Clinical and Immunohistochemical Characteristics of Malignant Aortic Body Tumor in a Pekingese Dog (페키니즈에서 발생한 악성 대동맥체 종양의 임상양상과 면역조직화학적 특성)

  • Kim, Won-Jung;Kim, Seung-Gon;Lee, Chang-Min;Kim, Dae-Young;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.407-411
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    • 2014
  • A 12-year-old castrated male Pekingese dog was presented with weakness, exercise intolerance, and an episode of coughing started 2 weeks earlier upon presentation. Physical examination revealed a grade II/VI left systolic heart murmur. Echocardiographic examination revealed a pericardial effusion and a mass at the heart base located beside the left atrium. The mass beside the left atrium was also visible on the thoracic radiograph after drainage of the pericardial effusion. An aortic body tumor was definitely diagnosed based on postmortem histopathological examination and immunohistochemical staining for specific markers. The dog lived 234 days after diagnosis with only medical management and without recurrence of the pericardial effusion.