[Tricuspid Valve Replacement without Removing Transvenous Pacemaker Lead].

Transvenous pacemaker lead occasionally impairs tricuspid valve coaptation because of the direct injury like a perforation, the direct interference with the valve, or the adhesion between the pacemaker leads and the valve leaflets, resulting in severe tricuspid regurgitation. In these situation, tricuspid valve replacement (TVR) is selected after the exchange from transvenous lead to epicardial lead. However this procedure has some problems such as poor threshold of the endcardial lead, the injury and the difficulty in transvenous lead removal. We performed successful TVR without removing transvenous pacemaker lead after the fixation to the annulus of posterior leaflet in tricuspid valve. This technique is useful in a patient with tricuspid regurgitation due to the influence of the pacemaker lead.

Tricuspid Valve Replacement Preserving Endocardial Pacemaker Lead.

We describe a simple and reliable technique to replace the tricuspid valve preserving a permanent endocardial pacemaker lead. This technique avoids any direct contact between the pacemaker lead and the prosthetic valve, which protects the pacemaker lead from the mechanical stress of the valve prosthesis and preserves the prosthetic valve's function. doi: 10.1111/jocs.12747 (J Card Surg 2016;31:311-314).

[Primary left atrial myxofibrosarcoma; report of a case].

We herein report a very rare case of a primary left atrial myxofibrosarcoma. A 61-year-old female presented with dyspnea and a wet cough. Chest X-ray film showed cardiomegaly and pulmonary congestion. Echocardiography and computed tomography revealed a left atrial tumor obstructing blood flow to the left ventricle. She was diagnosed with acute congestive heart failure due to functional mitralstenosis secondary to a left atrial tumor, and an emergency operation was performed. The tumor, which occupied left atrium, attached to the posterior wall of the left atrium and to the mitral valve, but had not invaded the left atrial wall. The tumor was removed from the left atrial wall, preserving the mitral valve and valve leaflets. The patient's post operative course was uneventful. The pathological diagnosis was myxofibrosarcoma, which rarely develops in the heart.

[Primary cardiac leiomyosarcoma originating from the left atrium].

Primary malignant cardiac tumors occur extremely rarely. Among these, leiomyosarcomas are exceptionally rare. We described a case of left atrial leiomyosarcoma in which surgical intervention was followed by adjuvant radiation therapy. A 74-year-old male was admitted for dyspnea. Chest X-ray showed severe pulmonary congestion. Echocardiography revealed large tumor in the left atrium. Emergency operation was performed. The tumor invaded the left atrial wall and the mitral valve, and the lesion was resected as extensively as possible. Postoperative pathologic examination confirmed leiomyosarcoma. He underwent adjuvant radiotherapy postoperatively. However, early local recurrence was recognized. He died due to sudden circulatory collapse in 8th postoperative month. As cardiac leiomyosarcomas have extremely poor prognosis, complete resection and effective postoperative adjuvant therapy are necessary.