Tricuspid valve obstruction and right heart failure due to a giant right atrial myxoma arising from the superior vena cava

AbstractA 57-year-old female presented to emergency with features of right heart failure. On evaluation, she was found to have a large mass occupying right atrium (RA) completely and protruding into right ventricle through tricuspid valve. Intraoperatively, mass was seen arising from RA free wall with stony hard consistency. Histopathology revealed it to be myxoma. We present this case for the rare presentation of myxoma masquerading as malignancy.

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Persistent left superior vena cava in patient with right atrial myxoma undergoing open heart surgery. A case report and review of literature

Saudi Journal of Anaesthesia ◽

10.4103/sja.sja_511_19 ◽

2020 ◽

Vol 14 (2) ◽

pp. 217

Author(s):

Mostafa Elhamamsy ◽

A Aldemerdash ◽

F Zahran ◽

BM Bakir ◽

NoufA Alanazi ◽

...

Keyword(s):

Heart Surgery ◽

Superior Vena ◽

Open Heart Surgery ◽

Vena Cava ◽

Atrial Myxoma ◽

Right Atrial ◽

Review Of Literature ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena ◽

Right Atrial Myxoma

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Massively dilated right atrium masquerading as a mediastinal tumor

Clinics and Practice ◽

10.4081/cp.2011.e20 ◽

2011 ◽

Vol 1 (1) ◽

pp. 20

Author(s):

Thomas Schroeter ◽

Nicolas Doll ◽

Sreekumar Subramanian ◽

Friedrich W. Mohr ◽

Michael A. Borger

Keyword(s):

Heart Failure ◽

Tricuspid Valve ◽

Right Atrium ◽

Mediastinal Tumor ◽

Right Heart Failure ◽

Right Atrial ◽

Right Heart ◽

Tricuspid Valve Insufficiency ◽

Valve Insufficiency ◽

The Right

Severe tricuspid valve insufficiency causes right atrial dilatation, venous congestion, and reduced atrial contractility, and may eventually lead to right heart failure. We report a case of a patient with severe tricuspid valve insufficiency, right heart failure, and a massively dilated right atrium. The enormously dilated atrium compressed the right lung, resulting in a radiographic appearance of a mediastinal tumor. Tricuspid valve repair and reduction of the right atrium was performed. Follow up examination revealed improvement of liver function, reduced peripheral edema and improved New York Heart Association (NYHA) class. The reduction of the atrial size and repair of the tricuspid valve resulted in a restoration of the conduit and reservoir function of the right atrium. Given the chronicity of the disease process and the long-standing atrial fibrillation, there is no impact of this operation on right atrial contraction. In combination with the reconstruction of the tricuspid valve, the reduction atrioplasty will reduce the risk of thrombembolic events and preserve the right ventricular function.

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Intermittent Occlusion of the Superior Vena Cava to Improve Hemodynamics in Patients With Acutely Decompensated Heart Failure: The VENUS-HF Early Feasibility Study

Circulation Heart Failure ◽

10.1161/circheartfailure.121.008934 ◽

2022 ◽

Author(s):

Navin K. Kapur ◽

Michael S. Kiernan ◽

Irakli Gorgoshvili ◽

Rayan Yousefzai ◽

Esther E. Vorovich ◽

...

Keyword(s):

Heart Failure ◽

Superior Vena Cava ◽

Urine Output ◽

Superior Vena ◽

Vena Cava ◽

Decompensated Heart Failure ◽

Right Atrial ◽

Acutely Decompensated Heart Failure ◽

Pulmonary Capillary ◽

Wedge Pressure

Background: Reducing congestion remains a primary target of therapy for acutely decompensated heart failure. The VENUS-HF EFS (VENUS-Heart Failure Early Feasibility Study) is the first clinical trial testing intermittent occlusion of the superior vena cava with the preCARDIA system, a catheter mounted balloon and pump console, to improve decongestion in acutely decompensated heart failure. Methods: In a multicenter, prospective, single-arm exploratory safety and feasibility trial, 30 patients with acutely decompensated heart failure were assigned to preCARDIA therapy for 12 or 24 hours. The primary safety outcome was a composite of major adverse cardiovascular and cerebrovascular events through 30 days. Secondary end points included technical success defined as successful preCARDIA placement, treatment, and removal and reduction in right atrial and pulmonary capillary wedge pressure. Other efficacy measures included urine output and patient-reported symptoms. Results: Thirty patients were enrolled and assigned to receive the preCARDIA system. Freedom from device- or procedure-related major adverse events was observed in 100% (n=30/30) of patients. The system was successfully placed, activated and removed after 12 (n=6) or 24 hours (n=23) in 97% (n=29/30) of patients. Compared with baseline values, right atrial pressure decreased by 34% (17±4 versus 11±5 mm Hg, P <0.001) and pulmonary capillary wedge pressure decreased by 27% (31±8 versus 22±9 mm Hg, P <0.001). Compared with pretreatment values, urine output and net fluid balance increased by 130% and 156%, respectively, with up to 24 hours of treatment ( P <0.01). Conclusions: We report the first-in-human experience of intermittent superior vena cava occlusion using the preCARDIA system to reduce congestion in acutely decompensated heart failure. PreCARDIA treatment for up to 24 hours was well tolerated without device- or procedure-related serious or major adverse events and associated with reduced filling pressures and increased urine output. These results support future studies characterizing the clinical utility of the preCARDIA system. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03836079.

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En-bloc resection and superior vena cava: right atrial reconstruction for chondrosarcoma infiltrating to superior vena cava and right heart

Chirurgia ◽

10.23736/s0394-9508.17.04689-7 ◽

2018 ◽

Vol 31 (2) ◽

Author(s):

Joyce W. Chan ◽

Peter S. Yu ◽

Ki K. Li ◽

Jacky Y. Ho ◽

Simon C. Chow ◽

...

Keyword(s):

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

En Bloc Resection ◽

Bloc Resection ◽

Right Atrial ◽

Right Heart ◽

En Bloc

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ID: 5: ISOLATED SUPRA-CARDIAC PARTIAL ANOMALOUS PULMONARY VENOUS CONNECTION CAUSING RIGHT HEART FAILURE

Journal of Investigative Medicine ◽

10.1136/jim-2016-000120.16 ◽

2016 ◽

Vol 64 (4) ◽

pp. 918.2-919 ◽

Cited By ~ 1

Author(s):

R Sogomonian ◽

H Alkhawam ◽

S Lee ◽

JJ Lieber ◽

EA Moradoghli Haftevani

Keyword(s):

Pulmonary Vein ◽

Superior Vena Cava ◽

Ventricular Hypertrophy ◽

Superior Vena ◽

Vena Cava ◽

Right Heart Failure ◽

Right Heart ◽

Intact Atrial Septum ◽

The Right ◽

Anomalous Pulmonary Venous Connection

One of many causes of right heart failure (RHF) is partial anomalous pulmonary venous connection (PAPVC). We present a rare entity of isolated supra-cardiac PAPVC, as right pulmonary vein drains into the superior vena cava (SVC) with intact atrial septum, precipitating RHF.A 55-year-old man with hypertension, diabetes mellitus, coronary artery disease, presenting with syncope. On examination blood pressure was 90/44 mm Hg and heart rate of 44 bpm, lungs were clear on auscultation, jugular venous distension was present, prominent S2 heart sound, and bilateral pitting edema of the lower extremities. Laboratory studies were significant for brain natriuretic peptide (BNP) of 504 pg/mL, troponin I of 0.06 ng/mL, and glycated hemoglobin (HgA1c) of 11.9%. Electrocardiography was significant for left atrial dilation and right ventricular hypertrophy. Transthoracic echocardiography (TTE) showed severe right ventricular dilation, left ventricular hypertrophy, and severe tricuspic regurgitation with pulmonary artery systolic pressure of 85 mm Hg. Additionally, on the TTE ejection fraction was noted to be 55% with no evidence of atrial septal defect (ASD). Cardiac catheterization and computed tomography angiogram (CTA) revealed severe pulmonary hypertension and drainage of the right pulmonary vein into the superior vena cava.We have described a case of an isolated supra-cardiac variant of right pulmonary vein draining into the SVC. ASD is absent in isolated form of PAPVC, our case demonstrated an intact atrial septum in a supra-cardiac variant. Studies have indicated that 82% of patients with PAPVC have an ASD, distinguishing our case as an uncommon entity.Patient was discharged with optimized doses of bumetanide, metoprolol, and was offered surgery for the definitive treatment. Surgical prognosis is excellent and the perioperative mortality rate is less than 0.1%.Abstract ID: 5 Figure 1Cardiac catheterization illustrating drainage from the right pulmonary vein anomalously into the superior vena cava.

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