RESUMO
We present the case of a 48 year-old male with a history of cystic fibrosis who presented with massive haemoptysis and was later found to have Takotsubo cardiomyopathy. He subsequently developed a left ventricular (LV) thrombus which was successfully removed via a left apical ventriculotomy. Surgical management of LV thrombus related to Takotsubo cardiomyopathy is warranted in a selected population of patients and a left apical ventriculotomy provides good access with minimal complications in the post operative setting.
Assuntos
Cardiomiopatia de Takotsubo/complicações , Trombose/etiologia , Fibrose Cística/complicações , Ventrículos do Coração/cirurgia , Hemoptise/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Trombose/cirurgiaRESUMO
We report a case of mitral valve annular dilatation caused by a large left atrial myxoma. A 69-year-old woman presented in pulmonary oedema. She was found to have a large left atrial myxoma prolapsing into the left ventricle in diastole causing severe functional mitral stenosis. At operation, the myxoma was completely excised from its attachment to the atrial septum. The mitral valve looked anatomically normal but the mitral annulus was dilated. The intraoperative Trans Oesophageal Echocardiogram (TOE) on weaning from cardiopulmonary bypass confirmed a dilated mitral annulus with moderate mitral regurgitation (MR). We elected not to place an annuloplasty ring in anticipation of improvement with postoperative remodelling. However, mitral regurgitation worsened after discharge becoming moderately severe and remains so after 1 year follow-up despite optimal medical treatment. This case suggests that annular dilatation can result from mechanical dilatation by a large left atrial myxoma. Intraoperative mitral valve annuloplasty should be considered in the presence of moderate MR as postoperative remodelling does not occur.
Assuntos
Neoplasias Cardíacas/cirurgia , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Mixoma/cirurgia , Idoso , Ponte Cardiopulmonar , Dilatação Patológica/diagnóstico por imagem , Dilatação Patológica/cirurgia , Ecocardiografia Transesofagiana/métodos , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico por imagem , Mixoma/diagnóstico por imagem , Fatores de TempoRESUMO
A 57-year-old man presented with worsening symptoms of shortness of breath and chest pain. He was found to have a giant Morgagni hernia with severe compression of his right ventricle on computed tomography scan. The hernia which contained greater omentum, small intestine and transverse colon was urgently repaired through a median sternotomy and laparotomy with a polypropylene mesh. Morgagni hernia is a type of congenital diaphragmatic hernia, which may not be symptomatic until adulthood. Presentation with this degree of right ventricular compression is rare.