RESUMEN
We report a case of a recurrence of 5 cardiac myxomas in both atria with atypical anatomical features difficult to image. Although a multimodality imaging was performed, three-dimensional echocardiography (3DE) was the only technique able to correctly identify all the recurrences and the anatomical characteristics of the myxomas. MRI detected the blood supply of the mass but even after careful review was able to identify only 4 of the 5 lesions. Even though it was already reported the usefulness of 3DE to better delineate the site of attachment of cardiac tumors, it was never reported its sensibility in the setting of multiple myxomas; this case highlights the ability of the 3DE in this challenging scenario and its potential for being considered the key adjunctive modality for the anatomy when advanced surgical plan is required.
Asunto(s)
Ecocardiografía Tridimensional/métodos , Atrios Cardíacos/patología , Mixoma/diagnóstico por imagen , Adulto , Femenino , Neoplasias Cardíacas/patología , Humanos , Imagen por Resonancia Magnética/métodos , Mixoma/cirugía , Recurrencia Local de Neoplasia/cirugía , Reoperación/métodos , Resultado del TratamientoRESUMEN
We report a case of a 55-year-old male admitted for cardiogenic embolic ischemic stroke work up. A transesophageal (TE) echocardiography (E) with contrast study to rule out patent foramen ovale (PFO) was performed; two-dimensional (2D) analysis did not detect any bubbles passage during Valsalva manoeuvre in the standard 2D cross sectional planes; further real time three-dimensional (3D) TEE imaging revealed passage of bubbles in the left atrium (LA) by both real-time 3DTEE imaging and by the 2D unconventional cross-sectional planes allowed by 3DTEE imaging. Even though 2DTEE is considered to be the gold standard modality for diagnosing PFO, it has some limitations. It has never been reported about usefulness of 3DTEE in PFO imaging. Even in the presence of only a report, our case suggests that 3DE could have an additional value and will compliment 2D imaging in PFO assessment.
Asunto(s)
Ecocardiografía Tridimensional/métodos , Ecocardiografía Transesofágica/instrumentación , Foramen Oval Permeable/diagnóstico , Medios de Contraste/administración & dosificación , Ecocardiografía Transesofágica/métodos , Accidente Cerebrovascular Embólico/complicaciones , Atrios Cardíacos/diagnóstico por imagen , Humanos , Accidente Cerebrovascular Isquémico/etiología , Masculino , Microburbujas , Persona de Mediana Edad , Maniobra de Valsalva/fisiologíaRESUMEN
We describe a case of giant pseudoaneurysm of the right pulmonary artery compressing the left atrium after percutaneous pulmonary valve implantation and right pulmonary artery dilatation. Such a complication mimicking an intracavity left atrial mass and treated successfully by stent placement has never, to the best of our knowledge, been reported. (Level of Difficulty: Beginner.).