scholarly journals P854 The role of multimodality imaging in revealing a rare cause of persistent ascites

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A M Buburuz ◽  
D T M Marcu ◽  
I Demsa ◽  
G Tinica ◽  
A Petris ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Right Atrium ◽  
Multimodality Imaging ◽  
Cardiac Myxoma ◽  
Right Atrial ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Tumor Type ◽  
The Right

Abstract Primary cardiac tumors are very rare causes of intracavitary masses, about 5% of all cardiac tumors. Most of them are benign tumors, and 50% are represented by atrial myxomas. They are usually developed in the left atrium, with a pedicle attached to the interatrial septum. Cardiac myxomas are one of the "greatest mimes" of pathology, with a polymorphic clinical presentation, from obstructive, to embolic and constitutional clinical manifestation. We present the case of a 58-year-old female patient with 4 years history of chronic obstructive pulmonary disease (COPD), on bronchodilator treatment and long-term oxygen therapy. She accused two months duration of abdominal distension due to ascites, for which she was evaluated in the gastroenterology department and received diuretics association. The symptoms were refractory to the treatment, so the patient was referred for cardiovascular examination. At presentation, the patient was afebrile, with a heart rate of 100/minute, blood pressure was 125/90 mmHg. Cardiovascular examination did not reveal any murmurs, jugular venous distension was present. 12-lead electrocardiogram (ECG): sinus rhythm, with right atrial enlargement. The transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) revealed a lobulated giant mass in RA, which occupied almost the entire cavity, with prolapse towards the right ventricle during diastole. Due to the large intracavitary mass, the point of attachment could not be ascertained. Computed tomography (CT) of the thorax was performed and it confirmed the presence of the giant right cardiac mass. The patient underwent surgical excision of the tumor under cardiopulmonary bypass. Intraoperative findings were represented by a yellowish-brown lobulated friable mass in the right atrium cavity, measuring 70/30/35 mm. The pedicle of the tumor was inserted on the free wall of the right atrium. The histopathological examination revealed round to stellate cells in a myxoid stroma, specific for cardiac myxoma. Postoperative evolution was influenced by the severe pulmonary disease, with prolonged mechanical ventilation and positive inotropic support, but it was slowly favorable, and the patient was discharged in good condition. Right atrial myxoma is a very rare intracardiac tumor with nonspecific forms of clinical presentations, that create difficulties in diagnosis. Ascites represents an unusual form of manifestation in a patient with a cardiac tumor. The insertion of the pedicle of the myxoma was atypical and induced difficulties in early evaluation of the tumor type. Even though myxomas are mainly benign tumors, the complication rate is very high, especially of embolic events due to the friable tumoral mass, so they can become life threatening conditions. Early diagnosis of cardiac myxoma based on multimodality imaging is essential, leading to optimal surgical management, with good long-term survival. Abstract P854 Figure. TEE view of giant RA tumor

Surgical Treatment of Primary Cardiac Tumors

1997 ◽  
Vol 5 (2) ◽  
pp. 101-103 ◽  
Author(s):  
Gu Chun Jiu ◽  
Bao Wei Ke ◽  
Guo Bin Xun ◽  
Yuan Hong ◽  
Xiu Zhong Yi
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Right Atrial ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Long Term Result ◽  
The Right ◽  
Medical University ◽  
Primary Cardiac Tumors

During a 16-year period from 1980 to 1996, 101 patients with primary cardiac tumors underwent surgery at the 1st Affiliated Hospital of China Medical University, which represented 2.44% of 4142 open-heart surgical cases during this period. Most tumors were benign; 94 were myxomas, 2 were fibromas, and 1 was a hemangioma. Three myxomas were in the right atrium and 91 were in the left atrium. The 4 malignant tumors comprised 2 mesothelioma, 1 histiocytoma, and 1 right atrial malignant myxoma. All benign tumors were completely excised with 4.95% mortality. Only 1 malignant tumor was completely excised. In our experience, the long-term result of surgical treatment of benign cardiac tumors is excellent, whereas the prognosis for patients with malignant cardiac tumors is very poor. The incidence of malignant tumors was lower than in other studies.

scholarly journals Benign tumors of the heart: Myxoma of the right atrium - a case report

2018 ◽  
Vol 75 (5) ◽  
pp. 512-515 ◽  
Author(s):  
Sasa Hinic ◽  
Jelena Saric ◽  
Predrag Milojevic ◽  
Jelena Gavrilovic ◽  
Tijana Durmic ◽  
...  
Keyword(s):  
Case Report ◽  
Body Position ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Benign Tumors ◽  
Non Invasive ◽  
Right Atrial Myxoma ◽  
The Right

Introduction. Myxoma is the most common primary benign heart tumor. The most frequent location is the left atrium, the chamber of the heart that receives oxygen- rich blood from the lungs. Myxomas usually develop in women, typically between the ages of 40 and 60. Symptoms may occur at any time, but most often they are asymptomatic or oligosymptomatic for a long period of time. Symptoms usually go along with body position, and are related to compression of the heart cavities, embolization and the appearance of general symptoms. The diagnosis of benign tumors of the heart is based on anamnesis, clinical features and findings of the tumor masses by use of non-invasive and invasive imaging methods. Extensive surgical resection of the myxoma is curative with minimal mortality. Long term clinical and echocardiographic follow-up is mandatory. Case report. We reported a case of a 62-year-old male, presented with 15 days of intermittent shortness of breath, dizziness and feeling of heart palpitations and subsequently diagnosed with right atrial myxoma based on transthoracic echocardiography . The patient was emergently operated in our hospital. Long-term followup did not reveal recurrence. Conclusion. Our case was an atypical localisation of right atrial myxoma. Whether the intracardiac mass is benign or malignant, early surgery is obligatory in order to prevent complications.

Cardiac Tumors: Surgical Experience in Thirty-Nine Cases

1996 ◽  
Vol 4 (1) ◽  
pp. 14-17
Author(s):  
Rajendar Krishan Suri ◽  
Raghuvir Singh Kanwar ◽  
Harjinder Singh ◽  
Rajinder Singh Dhaliwal ◽  
Sandeep Singh Rana ◽  
...  
Keyword(s):  
Malignant Fibrous Histiocytoma ◽  
Malignant Tumors ◽  
Fibrous Histiocytoma ◽  
Postoperative Radiotherapy ◽  
Right Atrial ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Malignant Group ◽  
The Right

Over a period of 18 years, 39 cases of cardiac tumors were operated upon in the Department of Cardiothoracic Surgery at the Postgraduate Institute of Medical Education and Research, Chandigarh. These included 34 (87%) patients with benign tumors and 5 (13%) patients with primary malignant tumors. All the benign tumors were myxomas, of which 31 (91.2%) were in the left atrium and 3 (8.8%) in right atrium. Primary malignant tumors comprised 2 rhabdomyosarcomas, 1 angiosarcoma, 1 lymphoma and 1 case of pleomorphic malignant fibrous histiocytoma. The diagnosis was established by echocardiography, angiocardiography and computed tomography. In one case the diagnosis was made at autopsy. All myxomas, except tricuspid valve myxoma, were removed completely through right atrial or biatrial approach with the use of cardiopulmonary bypass. Four cases of primary malignant tumors were non-resectable. Near total resection of a malignant fibrous histiocytoma arising from the right middle pulmonary vein and left atrial junction was achieved. There were 2 operative deaths (5.1 %). The follow-up ranged from 3 months to 10 years with a mean of 5.7 years. There was 1 recurrence (2.9%) in the benign group. In the malignant group, 3 cases (60%) died within 5 to 8 months of surgery due to further local and metastatic spread of the tumor. The case of malignant fibrous histiocytoma was treated with postoperative radiotherapy to the right mediastinum and is doing well at follow-up 3 months after surgery.

scholarly journals The Questions of Tactics of Surgical Treatment of Primary Heart Tumors

2020 ◽  
pp. 28-31
Author(s):  
R. M. Vitovsky ◽  
V. V. Isaіenko ◽  
V. F. Onishchenko ◽  
O. A. Pishchurin ◽  
D. М. Dyadyun ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Functional Class ◽  
Right Atrial ◽  
Long Term Results ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Nyha Functional Class ◽  
Nyha Classification ◽  
Heart Tumors ◽  
The Right

  Introduction. In the structure of cardiac neoplasms, myxoma accounts for 80–90% of benign heart tumors. The frequency of diagnosis of primary heart tumors (PHT), of which more than 80% are morphologically benign tumors, ranges from 0.09% to 1.9% of the total number of hospitalized patients. The aim of the study is to identify important issues of diagnosis and tactics of the surgical treatment of primary heart tumors. Material and methods. At the In Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine for the period from January 1, 1969 to January 1, 2019, 962 patients operated due to primary cardiac tumors. The myxomas of heart (MH) founded in 856 (89.0%) patients, of which in 752 (87.8%) cases – MH of left atrium (LA). The right atrial myxomas (RA) were diagnosed in 77 (9.0%) cases, MH in the left (LV) and in the right (RV) ventricles each in 8 (0.9%) cases, respectively. Multicentric tumor growth with the damage of two or three chambers of the heart was found in 11 (1.3%) patients. The age of patients with MH was from 3 to 78 years old (the middle age 47.5 ± 3.4), of which 621 (72.6%) were between 31 and 60 years old. Non-myxomic benign tumors were observed in 37 (3.9%) cases, malignant tumors – in 67 (7.0%) cases. Results and discussion. The III and IV functional classes according to the NYHA classification included 311 (36.3%) and 73 (8.5%) patients, respectively, which in these groups often required urgent surgical treatment. Hospital mortality over the past 19 years was 0% in the surgical treatment of MH, namely, 493 operations performed without lethal outcomes. Conclusions. The accepted tactics of emergency diagnosis and surgical intervention ensures the effectiveness of treatment with MH, as evidenced by the data of long-term results: 574 (78.3%) patients assigned to the NYHA functional class I, and 108 (14.8%) patients to NYHA functional class II. Survival rate up to 20 years was 79.8%.

A rare case of a right atrial lipoma originating from the superior vena cava: review, diagnosis and management

2021 ◽  
Author(s):  
George H Nasr ◽  
Michael Johl ◽  
Steven Sinfield ◽  
Cy Kim ◽  
Fabio Sagebin ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Rare Case ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
The Right ◽  
Primary Cardiac Tumors

Primary cardiac tumors are usually found incidentally on imaging and are much less common than tumors that metastasize to the heart. Cardiac lipomas are benign cardiac tumors that are usually found in the right atrium or left ventricle. Primary intravascular venous lipomas of the great cardiac vessels are extremely rare and there are few reported cases of a lipoma originating from the superior vena cava causing direct compressive intracardiac effects. Here we describe a case of a symptomatic right atrial lipoma originating from the superior vena cava.

scholarly journals Right Atrial Tumor Resection and Reconstruction with Use of an Acellular Porcine Bladder Membrane

2016 ◽  
Vol 43 (2) ◽  
pp. 175-177 ◽  
Author(s):  
Walid K. Abu Saleh ◽  
Odeaa Al Jabbari ◽  
Basel Ramlawi ◽  
Brian A. Bruckner ◽  
Matthias Loebe ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Right Atrium ◽  
Tumor Resection ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
Atrial Wall ◽  
Cardiac Reconstruction ◽  
Primary Cardiac Sarcoma ◽  
The Right ◽  
Atrial Tumor

Malignant cardiac tumors typically have a grave prognosis; their resection with negative margins is optimal. We present the case of a 21-year-old woman in whom we surgically resected a primary cardiac sarcoma and reconstructed the right atrium with use of a porcine urinary bladder membrane—the MatriStem® Surgical Matrix PSMX. The patient recovered uneventfully. Six months postoperatively, the right atrial wall had retained its integrity. In addition to our patient's case, we discuss the benefits of using the MatriStem membrane in cardiac reconstruction.

scholarly journals P860 Multimodality imaging of multiple recurrent myxomas: the role of three dimensional echocardiography

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
H Al Sergani ◽  
B Alamro ◽  
M Al Admawi ◽  
A Rahim ◽  
O Vriz ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Right Atrium ◽  
Left Atrial ◽  
Multimodality Imaging ◽  
Three Dimensional ◽  
Interatrial Septum ◽  
Small Mass ◽  
Right Atrial ◽  
Posterior Commissure ◽  
The Right

Abstract A 33-year-old lady who underwent left atrial myxoma resection was found to have on a 3 years follow up transthoracic echocardiography (E) a multilobular mass in the right atrium. A 2D transesophageal echocardiogram (TEE) was performed. Two Multi-lobulated masses were seen in the right atrium(RA); one bigger attached by a peduncle to the atrial wall in between the interatrial septum (IAS) and the superior vena cava and one smaller attached to the inferior RA wall; a remnant likely a suture was seen on the right side of the fossa ovalis; another small mass was noted on the left atrial (LA) side of the IAS; a small mass attached close to the posteromedial commissure and P3 scallop of the mitral valve was also detected. The RA mass was partially protruding into the tricuspid valve during diastole with no significant obstruction to flow. Three dimensional TEE allows an anatomical imaging able to identify the peduncles of two right atrial masses and three LA masses that were confirmed at surgery and consistent with cardiac myxoma at histopathology : one close the previous resection area, one at the opening of the LAA (panel A, white arrow) and one close to the posterior commissure of mitral valve (panel B, yellow arrow) and that were not seen by 2D. Magnetic resonance imaging (MRI) with contrast identified and showed opacification of : two masses in the RA with the pedicles ; - one mass on the LA side of interatrial septum; - one mass close to mitral valve posterior commissure ; however it was not able to detect the small mass close to the LAA. In our case 2D Echocardiography and MRI were able to identify 4 of the 5 recurrences found at surgery. 3D TEE was the only technique able to identify all 5 lesions. MRI is considered the gold standard for detecting cardiac tumor masses; however, even after careful review, it was not possible to identify the presence of the mass close to LAA. In particular 3D TEE was able to image the left atrial masses by an "en face view" of the left atrium from above. In addition, the unique 2D planes in unconventional views allow a more clear identifications of the peduncles of the masses in the right atrium. The identification of the peduncles is mainstay for the diagnosis of recurrent myxomas and exclude other tumors like metastasis or sarcomas. In fact multiple recurrence are very rare in particular if we consider that are in the two atria. Genetic tests for Carney complex were negative. The MRI allowed to confirm the vascularization of the contrast and to identify the peduncles of two masses in the right atrium. A multimodality imaging is able to correctly detect recurrent myxomas by identifying the anatomical features and the vascularization and lead to the diagnosis ; 3DE was the only technique able to correctly identify all the recurrent myxomas and and its use has the potential for being considered the key adjunctive modality for the anatomy when advanced surgical plan is required. Abstract P860 Figure.

Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 96 ◽  
Author(s):  
Osman Tansel Dar�in ◽  
Alper Sami Kunt ◽  
Mehmet Halit Andac
Keyword(s):  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Complete Recovery ◽  
Interatrial Septum ◽  
Right Atrial ◽  
Atrial Wall ◽  
Residual Shunt ◽  
Asd Closure ◽  
The Right

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

scholarly journals Neonatal cardiogenic shock revealing obstructive cardiac Hibernoma: case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rym Gribaa ◽  
Marwen Kacem ◽  
Sami Ouannes ◽  
Wiem Majdoub ◽  
Houssem Thabet ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Transthoracic Echocardiography ◽  
Right Atrium ◽  
Benign Tumors ◽  
Histopathological Analysis ◽  
Tricuspid Valve Repair ◽  
Flow Measurements ◽  
Surgical Specimen ◽  
Eosinophilic Cytoplasm ◽  
The Right

Abstract Background Cardiac Hibernomas are very rare benign tumors and usually remain asymptomatic. Neonatal cardiogenic shock due to cardiac tumors is extremely very rare. Until this date a few cases of cardiac hibernoma have been reported in the literature. Transthoracic echocardiography help in the differential diagnosis, but the definitive diagnosis is histological. The management strategy is not clearly codified. The Aim is to report and discuss the clinical features of a cardiac Hibernoma and review the relevant literature. Case presentation We describe a case of a 2-day-old Caucasian full-term male neonate admitted in neonate intensive care with cardiogenic shock, having fluid resuscitation and inotropic drugs. Ventilatory support was started immediately with the subsequent reestablishment of normal blood pressure. Then he was transferred to the echocardiography laboratory. Transthoracic echocardiography showed two echogenic masses in the right atrium and right ventricle. The masses were extended to the pulmonary trunk. Pulmonary artery flow measurements showed the presence of pulmonary and tricuspid obstruction. Surgery was rapidly considered since the baby was hemodynamically unstable. Intraoperative evaluation showed a mass embedded in the interventricular septum that occupy the right ventricular cavity and the right atrium. The tumor involved also the chordae of the tricuspid. Partial resection was done. Tricuspid valve repair was performed by construction of new chordae from the autologous pericardium. The specimen was sent for histopathological analysis. The baby died immediately after surgery. Histological examination of the surgical specimen revealed clear multivacuolated cells filled with lipid droplets and granular intense eosinophilic cytoplasm which confirms the diagnosis of Hibernoma. Conclusion Cardiac Hibernomas are rare benign tumors. The prognosis and treatment strategy is closely dependent on the location, initial clinical presentation and possible complications. The prognosis can be unfavorable if the tumor was obstructive and infiltrate the myocardium.

scholarly journals Large papillary fibroelastoma of right atrium, an unusual case of respiratory distress in a young man

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yan Le Ho ◽  
Pui Fong Ng ◽  
Sotheenathan Krishinan ◽  
Basheer Ahamed Abdul Kareem
Keyword(s):  
Right Atrium ◽  
Clinical Manifestations ◽  
Clinical Information ◽  
Interatrial Septum ◽  
Papillary Fibroelastoma ◽  
Case Presentation ◽  
Intracardiac Masses ◽  
The Right ◽  
Embolic Risk

Abstract Background Papillary fibroelastomas are rare but benign cardiac tumour that are often found on cardiac valvular surfaces. Their clinical manifestations ranging from clinically asymptomatic to substantial complications that are usually secondary to systemic embolism. Multiple theories have been proposed to explain the pathophysiology of its formation. Case presentation We reported a rare case of large papillary fibroelastoma in the right atrium of a young gentleman which was complicated with pulmonary embolism. Transthoracic echocardiography identified a large pedunculated mass measuring 3.4cmX3.4cmX2cm in right atrium with stalk attached to interatrial septum. The intracardiac mass was resected surgically, which revealed papillary fibroelastoma in histology examination. Conclusion Differential diagnosis of intracardiac masses requires clinical information, laboratory tests and imaging modalities including echocardiography. Incidentally discovered papillary fibroelastomas are treated on the basis of their sizes, site, mobility and potential embolic complications. Due to the embolic risk inherent to intraacardiac masses, surgical resection represents an effective curative protocol in treating both symptomatic and asymptomatic right sided and left sided papillary fibroelastomas, with excellent long term postoperative prognosis.

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