RESUMO
Cardiac myxoma is a benign primary cardiac tumor. Herein, we report a case of mitral regurgitation due to annular dilatation caused by giant left atrial myxoma. The transthoracic echocardiogram performed in a 65-year-old man who suffered from worsening exertional dyspnea detected a large mass of 81 × 31 mm in the left atrium, causing functional severe mitral stenosis. Radical mass resection was performed. After removal of the aortic clamp, an intraoperative transesophageal echocardiogram revealed moderate mitral regurgitation due to annulus dilatation. Mitral annuloplasty was performed, and mitral regurgitation was controlled. The mass was diagnosed as myxoma histologically. A large myxoma that affects mitral annulus dilatation is rarely reported. Mitral regurgitation may be masked by the presence of a large myxoma. Therefore, it should be carefully evaluated after resection, and mitral annuloplasty should be considered in the presence of significant mitral regurgitation due to mechanical annulus dilatation caused by myxoma.
Assuntos
Aneurisma da Aorta Torácica/diagnóstico por imagem , Dissecção Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/diagnóstico por imagem , Implante de Prótese Vascular/métodos , Implante de Prótese de Valva Cardíaca/métodos , Anel Vascular/diagnóstico por imagem , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Dissecção Aórtica/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Estenose da Valva Aórtica/cirurgia , Bioprótese , Terapia Combinada , Angiografia por Tomografia Computadorizada/métodos , Ecocardiografia/métodos , Tratamento de Emergência , Feminino , Seguimentos , Humanos , Imageamento Tridimensional , Doenças Raras , Síncope/diagnóstico , Síncope/etiologia , Fatores de Tempo , Resultado do Tratamento , Anel Vascular/cirurgiaRESUMO
We report a case of a 55-year-old male with type B-chronic aortic dissection. Patient presented with intermittent claudication due to limb malperfusion resulting from expansion of a patent false lumen during walking regardless of normal range ankle-brachial index (ABI) at rest. Preoperative stress vascular ultrasonography was an effective modality for proper diagnosis. We should be concerned of reversible ischemia due to the dissection flap in patients with type B aortic dissection. Fenestration of the aorta can be a choice of treatment in such patients. The patient has been doing well with no ischemia for 3.5 years after the operation.
RESUMO
Bronchogenic cyst is a rare developmental lesion. It can cause symptoms only when infected or pressing on neighboring structures. A 56-year-old woman presenting with orthopnea and chest pain was found to have a bronchogenic cyst compressing the right pulmonary artery and the left atrial roof. The mass adhered to surrounding structures and complete resection of the mass seemed to be technically impossible. Accordingly, a direct ethanol injection therapy with median sternotomy approach was accomplished. After the procedure the patient's symptoms disappeared and the follow-up computed tomography 21 months later revealed no relapse. Though the complete resection of bronchogenic cysts is recommended to confirm the diagnosis, to prevent development of complications, and to avoid recurrences, ethanol injection therapy is still a valid option in some cases.
Assuntos
Cisto Broncogênico/cirurgia , Etanol , Átrios do Coração/cirurgia , Artéria Pulmonar/cirurgia , Esternotomia , Cisto Broncogênico/complicações , Feminino , Átrios do Coração/patologia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Imagem Multimodal , Artéria Pulmonar/patologia , Tomografia Computadorizada por Raios XAssuntos
Doenças da Aorta/etiologia , Estenose da Valva Aórtica/cirurgia , Cardiopatias/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Fístula Vascular/etiologia , Idoso , Doenças da Aorta/diagnóstico , Doenças da Aorta/cirurgia , Anuloplastia da Valva Cardíaca , Ecocardiografia Doppler em Cores , Ecocardiografia Transesofagiana , Feminino , Átrios do Coração/diagnóstico por imagem , Cardiopatias/diagnóstico , Cardiopatias/cirurgia , Insuficiência Cardíaca/etiologia , Humanos , Reoperação , Técnicas de Sutura , Resultado do Tratamento , Fístula Vascular/diagnóstico , Fístula Vascular/cirurgiaRESUMO
Congenital factor V deficiency is an uncommon bleeding disorder that necessitates hemostatic correction before surgery. We herein describe a patient with severe factor V deficiency who underwent successful off-pump coronary artery bypass grafting with a transfusion of fresh-frozen plasma.