[Endocardial Blood Cyst in the Right Atrium:Report of a Case].

A 74-years-old man visited our hospital complaining chest discomfort, and he was diagnosed with variant angina. However, during close examination, a tumor with some small calcified nodules was accidentally pointed out in the right atrium. We carried out surgical removal to prevent embolism. A cystic tumor attached to the atrial septum was resected together with the atrial septum, and the defect was closed with a Dacron patch. The tumor size was 18×25×3 mm. Histologically, its wall was consisted of connective tissue, which was positive for CD34, negative for calretinin, and was diagnosed as an endocardial blood cyst. A core of the nodules in the cyst were calcified and they were phleboliths. Postoperative echocardiography detected no residual mass or atrial septal defect, and he was discharged uneventfully.

[Impending Paradoxical Embolization in a Patient with a Thrombus Straddling the Patent Foramen Ovale].

The patent foramen ovale (PFO) is known as a risk of paradoxical embolism in patients with deep venous thromboses. However, PFO is usually found after systemic embolic symptoms become apparent. A 60-year-old male had complained of dyspnea for two weeks. Ultrasound echocardiography showed a thrombus straddling PFO, and venous echography showed blood clots in the right popliteal and soleus veins. Contrast computed tomography revealed multiple pulmonary embolisms and a thrombus in the right atrium expanding to the left atrium through the atrial septum. The straddling thrombus in the atrium and pulmonary thrombi were extirpated under circulatory arrest with deep hypothermia. An inferior vena cava filter was inserted intravenously four days after surgery. The patient was discharged on the 19th postoperative day without any signs of thromboembolism. Prompt surgery is considered important to prevent thromboembolism in the case of impending paradoxical embolism.

Vascular compression of the left bronchus in a patient with funnel chest.

We present a case of 5 year-old female with funnel chest, by which cardiovascular structures were displaced into the left chest cavity. This caused left bronchial compression by the pulmonary artery and the descending aorta, for which an external stenting was successfully performed. The patient had features suggestive of skeletal dysplasia with tracheobronchial malacia. One possible mechanism of vascular compression could be an association of fragility of the thoracic cavity and inspiratory dyspnea, causing thoracic deformity.

Surgical repair in a patient with Berry syndrome.

Berry syndrome is a trilogy involving an aorto-pulmonary window, right pulmonary artery from ascending aorta and an interrupted aortic arch. Surgical repair for this anomaly is associated with a high mortality rate and incidence of right pulmonary arterial stenosis. Herein, we present the case of a patient with Berry syndrome, who underwent a rapid two-stage repair involving bilateral pulmonary arterial banding and complete repair. Postoperative computed tomography scan showed well-repaired great vessels free of obstruction.