scholarly journals P1474 Right or left; which sided the infective endocarditis is?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A A Baskurt ◽  
E Ozpelit ◽  
Z Kumral ◽  
B Akdeniz
Keyword(s):  
Infective Endocarditis ◽  
Aortic Root ◽  
Right Atrium ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Transoesophageal Echocardiography ◽  
Right Atrial ◽  
Replacement Surgery ◽  
Reactive Protein ◽  
The Right

Abstract ABSTRACT Treatment and management of infective endocarditis (IE) depends on the side of involvement. Involvement of both sides of heart is rarely encountered. We describe one case of both sided infective endocarditis caused by staphylococcus auerus. In this case, the vegetation is thought to be on the right side of the heart at first examination by transthrorasic echocardiography (TTE). However; when examined more carefully with transoesophageal echocardiography (TEE), nothing was as it seemed. CASE PRESENTATİON A 86-year-old woman, who underwent mechanic aortic valve replacement surgery 11 years before, was admitted to emergency room with fever, dispnea and cough. Physical examination showed a temperature of 38.6. Electrocardiography showed a atrial fibrillation of 112 beats/min. Laboratory tests revealed an elevated C reactive protein of 211 mg/l. The patient was empirically treated with intravenous piperacillin-tazobactam and teicoplanin, by the recommendation of infection disease unit. Staphylococcus aureus grew in both bottles of blood cultures. A TTE showed severe tricuspid regurgitation with vegetation, mild aortic regurgitation and moderate mitral regurgitation with no clear vegetation. We decided perform TEE and realised the vegetation in the right atrium was originated from the right atrial wall not from the tricuspid valve. Then we also noticed a thickening in the walls of aortic root with systolic expansion. This finding was consistent with paraaortic abscess formation. The 3D TEE examination helped us to understand the origin of the vegetation in the right atrium. Because the wall of the right atrium which the vegetation arised from was in direct continuity with the infected aortic root. We conclude that the paraortic abscess was spread to the right atrium by neighborhood. After one week of IV antibiotics treatment, the patient undergone open heart surgery. The surgical inspection confirmed the echocardiographic diagnosis. DISCUSSION Echocardiography helps us in diagnosis, determination of side of involvement, and complications of infective endocarditis. Usually the endocarditis invole only one side of the heart: left or right. We have found only four cases of double-sided endocarditis in literature. Our case is the first one , in which we describe a direct extension of aortic root abscess to the right atrium. Abstract P1474 figure 1

scholarly journals A rare case of obstructive right atrial lipoma

2014 ◽  
Vol 96 (7) ◽  
pp. e39-e41 ◽  
Author(s):  
A Habertheuer ◽  
M Andreas ◽  
D Wiedemann ◽  
C Rath ◽  
A Kocher
Keyword(s):  
Right Atrium ◽  
Heart Surgery ◽  
Elective Surgery ◽  
Hypertensive Crisis ◽  
Open Heart Surgery ◽  
Vena Cava ◽  
Right Atrial ◽  
Caucasian Woman ◽  
Cardiac Tumours ◽  
The Right

Benign cardiac tumours are rare and cardiac lipomas account only for a small fraction among those. Most of these tumours differ in terms of clinical manifestation, diagnosis, morphology and size, and are therefore not diagnosed easily unless they become symptomatic. We report the case of a 71-year-old Caucasian woman with recurrent episodes of shortness of breath presenting with an acute exacerbation of dyspnoea and hypertensive crisis. Diagnosis of a right atrial lipoma with a coexisting patent foramen ovale was established on echocardiography and computed tomography, and the patient was evaluated for elective surgery. Comprising the entire free wall of the right atrium, the tumour was removed during open heart surgery on cardiopulmonary bypass. The right atrium and the orifices of both the superior and inferior vena cava were reconstructed with bovine pericardium. No evidence of tumour relapse was observed during successive follow-up visits.

scholarly journals Right Atrial Blood Cyst with Stones Suspended from the Coronary Sinus

2019 ◽  
Vol 19 (2) ◽  
pp. 161
Author(s):  
Feridoun Sabzi ◽  
Aghigh Heydari ◽  
Atefeh Asadmobini ◽  
Mohammad B. Heidari
Keyword(s):  
Coronary Sinus ◽  
Right Atrium ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Cystic Mass ◽  
Right Atrial ◽  
Operative Surgical Procedure ◽  
Small Stone ◽  
Chiari Network ◽  
The Right

ABSTRACT: Cardiac blood cysts are rare benign neoplasms, usually involving the cardiac valves and are remnants of the Chiari network. They are usually detected in the first six months of life and rarely occur in children or adults. We report a 76-year-old male patient who was referred to the Imam Ali Hospital affiliated with Kermanshah University of Medical Sciences, Kermanshah, Iran, in 2018 with dyspnoea. Transthoracic echocardiography revealed a small patent foramen ovale (PFO) and a circumferential mobile cystic mass in the right atrium, with the impression of a tumour or thrombus. The patient underwent open-heart surgery with cardiopulmonary bypass to repair to PFO and remove the intra-atrial lesion. During surgical examination of the right atrial cavity, a blood cyst containing small stone-like structures on the coronary sinus valve of the right atrium was found. The post-operative course was uneventful and no recurrence of tumour was detected during six months of follow-up. To the best of our knowledge, this is the first reported case of a right atrial blood cyst with a few nodule-like stones in an adult with PFO in Iran and the second case in an adult with PFO worldwide.Keywords: Cyst; Coronary Sinus; Adult; Operative Surgical Procedure; Case Report; Iran.

scholarly journals Atrial Fibrillation Progression Is Associated with Cell Senescence Burden as Determined by p53 and p16 Expression

2019 ◽  
Vol 9 (1) ◽  
pp. 36
Author(s):  
Laurence Jesel ◽  
Malak Abbas ◽  
Sin-Hee Park ◽  
Kensuke Matsushita ◽  
Michel Kindo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Right Atrial ◽  
Atrial Remodeling ◽  
Inflammatory Proteins ◽  
Underlying Mechanisms ◽  
The Right ◽  
New Evidence

Background: Whilst the link between aging and thrombogenicity in atrial fibrillation (AF) is well established, the cellular underlying mechanisms are unknown. In AF, the role of senescence in tissue remodeling and prothrombotic state remains unclear. Aims: We investigated the link between AF and senescence by comparing the expression of senescence markers (p53 and p16), with prothrombotic and inflammatory proteins in right atrial appendages from patients in AF and sinus rhythm (SR). Methods: The right atrial appendages of 147 patients undergoing open-heart surgery were harvested. Twenty-one non-valvular AF patients, including paroxysmal (PAF) or permanent AF (PmAF), were matched with 21 SR patients according to CHA2DS2-VASc score and treatment. Protein expression was assessed by tissue lysates Western blot analysis. Results: The expression of p53, p16, and tissue factor (TF) was significantly increased in AF compared to SR (0.91 ± 0.31 vs. 0.58 ± 0.31, p = 0.001; 0.76 ± 0.32 vs. 0.35 ± 0.18, p = 0.0001; 0.88 ± 0.32 vs. 0.68 ± 0.29, p = 0.045, respectively). Expression of endothelial NO synthase (eNOS) was lower in AF (0.25 ± 0.15 vs. 0.35 ± 0.12, p = 0.023). There was a stepwise increase of p53, p16, TF, matrix metalloproteinase-9, and an eNOS progressive decrease between SR, PAF, and PmAF. AF was the only predictive factor of p53 and p16 elevation in multivariate analysis. Conclusions: The study brought new evidence indicating that AF progression is strongly related to human atrial senescence burden and points at a link between senescence, thrombogenicity, endothelial dysfunction and atrial remodeling.

scholarly journals Right-sided infective endocarditis complicating central venous line insertion: a case report

2019 ◽  
Vol 1 (1) ◽  
pp. 19-22
Author(s):  
Aram Mirza ◽  
Kawa Hassan ◽  
Farman Ahmed
Keyword(s):  
Infective Endocarditis ◽  
Heart Surgery ◽  
Guide Wire ◽  
Artery Bypass ◽  
White Blood Cells ◽  
Open Heart Surgery ◽  
Central Venous Line ◽  
Central Venous ◽  
Reactive Protein ◽  
Valve Tissue

Abstract Infective endocarditis is a serious and potentially fatal complication of central venous line (CVL) placement in patients with diseased hearts. A man of 59 was admitted because of fever and dyspnea of 5 days duration. He was a known case of ischemic cardiomyopathy with frequent admissions to a local hospital. Two months earlier, a CVL was placed in right subclavian vein for drug administration. On examination, he was febrile and hypotensive with a systolic murmur in tricuspid and mitral areas. CVL- guide wire was radiographically visible. White blood cells and C-reactive protein were elevated. Echocardiography showed big vegetation on tricuspid valve (TV), severe mitral and tricuspid regurgitation and dilated left ventricle whilst coronary angiography revealed 3-vessel disease. Antibiotic therapy was followed by an open heart surgery during which the guide wire and valve vegetation were removed, TV was repaired, mitral valve was replaced and coronary artery bypass grafting was performed. Culture of blood, valve tissue and guide wire grew Staphylococcus Epidermidis. Despite intensive medical and surgical therapy, the patient succumbed on the 4th postoperative day.

scholarly journals A Giant Right Atrial Myxoma with Blood Supply from the Left and Right Coronary Arteries: Once in a Blue Moon

2020 ◽  
Vol 4 (3) ◽  
pp. 201-204
Author(s):  
Yichao Xiao ◽  
Zhenfei Fang ◽  
Xinqun Hu ◽  
Qiming Liu ◽  
Zhaowei Zhu ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
Right Atrial Mass ◽  
Right Atrial Myxoma ◽  
Left And Right ◽  
Cardiac Myxomas ◽  
The Right

Cardiac myxomas, the commonest primary benign cardiac tumors, are extremely rare, with an incidence ranging from 0.0017 to 0.19% and only about one-fifth of them originating from the right chambers of the heart. A 60-year-old woman was admitted because of recurrent attacks of chest tightness and shortness of breath. Transthoracic echocardiography detected a giant mass in the right atrium; myxoma was indicated by [18F]fluorodeoxyglucose PET/CT. Preoperative selective coronary angiography was performed to assess the extent and severity of coronary stenosis, and showed a strongly neovascularized right atrial mass supplied by two feeding vessels with multiple branches from the left and right coronary arteries. The myxoma was successfully excised with open heart surgery and the patient was free of myxoma recurrence during the 3-year follow-up.

Right Atrial Ball Thrombus as a Complication of Subclavian Catheter Insertion for Hemodialysis Access

1987 ◽  
Vol 10 (2) ◽  
pp. 102-104 ◽  
Author(s):  
E.C.R. Wijeyesinghe ◽  
Y. Pei ◽  
S.S.A. Feritori ◽  
P.R. Uldall
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Right Atrial ◽  
Open Heart ◽  
Hemodialysis Access ◽  
Atrial Wall ◽  
Catheter Tip ◽  
Subclavian Catheter ◽  
The Right ◽  
Ball Thrombus

In two patients right atrial ball thrombi developed following prolonged subclavian cannulation for hemodialysis. One patient died, the other had the ball thrombus removed by open heart surgery. It appears that repeated friction of the catheter tip may have damaged the endothelium of the right atrial wall. This hitherto unrecognised complication might be prevented by ensuring that subclavian hemodialysis catheters are never allowed to reach as far as the right atrium.

scholarly journals Surgical Treatment of Lutembacher Syndrome with a Huge Right Atrium: A Case Report

2021 ◽  
Vol 24 (2) ◽  
pp. E359-E362
Author(s):  
Maodong Yang ◽  
Li Zhang ◽  
Han Tang ◽  
Linsong Liu ◽  
Jian Wu
Keyword(s):  
Case Report ◽  
Right Atrium ◽  
Heart Surgery ◽  
Venous Pressure ◽  
Open Heart Surgery ◽  
Vital Signs ◽  
Rare Condition ◽  
Right Atrial ◽  
Breath Sounds ◽  
Apex Beat

Background: Lutembacher’s syndrome (LS) is a rare cardiovascular anomaly that is defined as any combination of congenital or iatrogenic atrial septal defect (ASD) with congenital or acquired mitral stenosis (MS). The clinical features and hemodynamic effects of LS depend on the balance between ASD and MS. Case Report: In this case report, we describe a rare case of LS with a huge right atrium in a 39-year-old male patient who was admitted to the hospital with worsening fatigue and breathlessness on exertion. Clinical examination revealed central cyanosis, raised jugular venous pressure bilaterally, clear breath sounds bilaterally with no dry and wet rales, hyperdynamic apex beat, and dull heart sounds. His vital signs on admission included blood pressure of 90/60 mmHg, irregular pulse of 76 beats/min, and oxygen saturation of 90.4%. Echocardiography revealed moderate to severe MS with ASD (ostium secundum). The patient’s condition deteriorated after initial medical management, and he underwent open heart surgery for mitral valve replacement, ASD repair, tricuspid annuloplasty, and right atrial volume reduction. Conclusions: This case report describes the successful surgical management of this rare condition.

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