scholarly journals Cardiac changes in mediastinal seminoma - a case report

2003 ◽  
Vol 131 (9-10) ◽  
pp. 403-407
Author(s):  
Branislava Ivanovic ◽  
Bosiljka Vujisic-Tesic ◽  
Dragana Jovanovic ◽  
Dimitra Kalimanovska-Ostric
Keyword(s):  
Left Atrium ◽  
Right Atrium ◽  
Pulmonary Veins ◽  
Distant Metastases ◽  
Large Mass ◽  
Right Atrial ◽  
Adjacent Structures ◽  
Arm Swelling ◽  
Mediastinal Seminoma ◽  
The Right

Primary pure cell seminoma of the mediastinum is a rare and potentially fatal lesion. Encroachment or invasion of adjacent structures is common, as are distant metastases. We present an unusual case of mediastinal seminoma with directly intracavitary invasion into the right atrium and extension to the left atrium. A 22-year-old male with right side chest pain, progressive cough, dispnea, fever and right arm swelling lasting about a month is presented. Chest radiography on admission revealed a large mass in the anterior mediastinum. A cardiac ultrasonographic examination showed right atrial compression by the mass, with invasion of the right atrium wall. We also found polyp-like (about 2.5 cm in diameter) masses in left atrium near the area of the right pulmonary veins and a circumferential pericardial effusion. Percutaneous needle biopsy revealed mediastinal seminoma. To our knowledge, no similar case has been previously reported.

scholarly journals Investigations Into the Distribution of Blood in the Heart and Aortic Arches of Xenopus Laevis (Daud.)

1957 ◽  
Vol 34 (2) ◽  
pp. 143-172 ◽  
Author(s):  
A. R. DE GRAAF
Keyword(s):  
Xenopus Laevis ◽  
Left Atrium ◽  
Right Atrium ◽  
Pulmonary Veins ◽  
The Body ◽  
Right Atrial ◽  
Considerable Proportion ◽  
Open Communication ◽  
Selective Distribution ◽  
The Right

The structure of the heart of Xenopus laevis is described, and the differences between Xenopus and Rana are stressed. 2. A fluorescein-cinematographic method of tracing blood flow and an optical manometer for the measurement of blood pressure in Xenopus are described. 3. The right atrial blood is absorbed into the trabecular meshwork only on the right side of the ventricle. 4. Whereas the output of the right atrium is not, or only in negligible quantities, transferred to the left side of the ventricle, a considerable proportion of the output of the left atrium moves to the right half of the ventricle. 5. The left atrium has a larger output than the right atrium. 6. Almost all the blood expelled from the right atrium is sent to the pulmo-cutaneous arches. 7. The blood from the left atrium is distributed to all the arterial arches and the pulmo-cutaneous arches receive a considerable proportion of this blood. 8. More blood flows through the pulmo-cutaneous arches at each beat than is sent through the carotid and systemic arches together. 9. The rate of flow in the pulmonary circuit is much higher than that in the body circuit. 10. A physiological connexion is demonstrated between the left side of the ventricle and the systemic and carotid arches, and between the right side of the ventricle and the pulmo-cutaneous arches. 11. Pressures in the pulmo-cutaneous arch are consistently lower than in either the carotid or systemic arches. 12. The pressures in the carotid and systemic arches are remarkably similar. There is, therefore, no sound reason for postulating a mechanism in the carotid labyrinths which should maintain a higher pressure in the carotids than in the systemics. 13. The pulse curves in the arches show two waves: the first, major, one produced by contraction of the ventricle, the second one by contraction of the bulbus cordis. 14. The spiral valve may not come into contact with the opposite wall of the bulbus before contraction of the latter. Before that time, i.e. as long as the major propulsive force of the ventricular contraction is not expended, the cavum pulmo-cutaneum is in open communication with the ventricle. 15. The pulmonary veins show a weak pulse, and their pressure is higher than in the hepatic veins. This indicates smaller resistance in the pulmonary circuit than in the body circuit. 16. The selective distribution is neither in agreement with the ‘classical theory’ nor with ideas of random distribution. 17. The forces underlying the selective distribution and the significance of the pattern are discussed.

scholarly journals P649 Before and after: sinus venosus atrial septal defect

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Marco Clement ◽  
R Eiros ◽  
R Dalmau ◽  
T Lopez ◽  
G Guzman ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Left Atrium ◽  
Atrial Flutter ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Septal Defect ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
The Right

Abstract Introduction The diagnosis of sinus venosus atrial septal defect (SVASD) is complex and requires special imaging. Surgery is the conventional treatment; however, transcatheter repair may become an attractive option. Case report A 60 year-old woman was admitted to the cardiology department with several episodes of paroxysmal atrial flutter, atrial fibrillation and atrioventricular nodal reentrant tachycardia. She reported a 10-year history of occasional palpitations which had not been studied. A transthoracic echocardiography revealed severe right ventricle dilatation and moderate dysfunction. Right volume overload appeared to be secondary to a superior SVASD with partial anomalous pulmonary venous drainage. A transesophageal echocardiography confirmed the diagnosis revealing a large SVASD of 16x12 mm (Figure A) with left-right shunt (Qp/Qs 2,2) and two right pulmonary veins draining into the right superior vena cava. Additionally, it demonstrated coronary sinus dilatation secondary to persistent left superior vena cava. CMR and cardiac CT showed right superior and middle pulmonary veins draining into the right superior vena cava 18 mm above the septal defect (Figures B and C). After discussion in clinical session, a percutaneous approach was planned to correct the septal defect and anomalous pulmonary drainage. For this purpose, anatomical data obtained from CMR and CT was needed to plan the procedure. During the intervention two stents graft were deployed in the right superior vena cava. The distal stent was flared at the septal defect level so as to occlude it while redirecting the anomalous pulmonary venous flow to the left atrium (Figure D). Control CT confirmed the complete occlusion of the SVASD without residual communication from pulmonary veins to the right superior vena cava or the right atrium (Figure E). Anomalous right superior and middle pulmonary veins drained into the left atrium below the stents. Transthoracic echocardiographies showed progressive reduction of right atrium and ventricle dilatation. The patient also underwent successful ablation of atrial flutter and intranodal tachycardia. She is currently asymptomatic, without dyspnea or arrhythmic recurrences. Conclusions In this case, multimodality imaging played a key role in every stage of the clinical process. First, it provided the diagnosis and enabled an accurate understanding of the patient’s anatomy, particularly of the anomalous pulmonary venous connections. Secondly, it allowed a transcatheter approach by supplying essential information to guide the procedure. Finally, it assessed the effectiveness of the intervention and the improvement in cardiac hemodynamics during follow-up. Abstract P649 Figure.

TYPES OF CORRECTION OF THE SUPRACARDIAC FORM OF PARTIAL ABNORMAL DRAINAGE OF THE PULMONARY VEINS. WARDEN PROCEDURE

2021 ◽  
pp. 28-31
Author(s):  
Inkar Sagatov ◽  
Nurzhan Dosmailov
Keyword(s):  
Left Atrium ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Artificial Circulation ◽  
The Right

The article describes the types of correction of the supracardial form of abnormal drainage of the pulmonary veins. One of the methods of correcting this defect is the Warden operation, which includes: after sternotomy, connection of artificial circulation, cardioplegia, the superior vena cava is cut off, the proximal end is sutured. Next, a right atriotomy is performed, an anastomosis is formed using an autopericardial patch between the abnormal drainage and the left atrium through the ASD. Then an anastomosis is formed between the auricle of the right atrium and the distal end of the superior vena cava. As a result, blood from the abnormal pulmonary veins begins to drain into the left atrium through the ASD.

scholarly journals The Value of Voltage Histogram Analysis Derived Right Atrial Scar Burden in the Prediction of Left Atrial Scar Burden

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Szilvia Herczeg ◽  
Joseph Galvin ◽  
John J. Keaney ◽  
Edward Keelan ◽  
Roger Byrne ◽  
...  
Keyword(s):  
Left Atrium ◽  
Right Atrium ◽  
Low Voltage ◽  
Histogram Analysis ◽  
Right Atrial ◽  
Analysis Tool ◽  
Invasive Treatment ◽  
Scar Burden ◽  
Tissue Burden ◽  
The Right

Introduction. Growing evidence suggests that fibrotic changes can be observed in atrial fibrillation (AF) in both atria. Quantification of the scar burden during electroanatomical mapping might have important therapeutic and prognostic consequences. However, as the current invasive treatment of AF is focused on the left atrium (LA), the role of the right atrium (RA) is less well understood. We aimed to characterize the clinical determinates of the RA low-voltage burden and its relation to the LA scaring. Methods. We have included 36 patients who underwent catheter ablation for AF in a prospective observational study. In addition to LA mapping and ablation, high-density RA bipolar voltage maps (HD-EAM) were also reconstructed. The extent of the diseased RA tissue (≤0.5 mV) was quantified using the voltage histogram analysis tool (CARTO®3, Biosense Webster). Results. The percentage of RA diseased tissue burden was significantly higher in patients with a CHA2DS2-VASc score ≥ 2 p=0.0305, higher indexed LA volume on the CTA scan and on the HD‐EAM (p=0.0223 and p=0.0064, respectively), or higher indexed RA volume on the HD‐EAM p=0.0026. High RA diseased tissue burden predicted the presence of high LA diseased tissue burden (OR = 7.1, CI (95%): 1.3–38.9, p=0.0145), and there was a significant correlation of the same (r = 0.6461, p<0.0001). Conclusions. Determining the extent of the right atrial low-voltage burden might give useful clinical information. According to our results, the diseased tissue burden correlates well between the two atria: the right atrium mirrors the left atrium.

Cardiac multispiral computed tomography: optimization of examination’s protocol for non-invasive cardaic mapping before catheter ablation of atrial fibrrillation

2018 ◽  
pp. 33-48
Author(s):  
N. Yu. Kashtanova ◽  
I. S. Gruzdev ◽  
E. V. Kondrat’ev ◽  
Е. A. Artyukhina ◽  
М. V. Yashkov ◽  
...  
Keyword(s):  
Left Atrium ◽  
Contrast Enhancement ◽  
Low Dose ◽  
Pulmonary Veins ◽  
Cardiac Mapping ◽  
Left Auricle ◽  
Contrast Injection ◽  
Adjacent Structures ◽  
The Right ◽  
Delayed Phase

Purpose:to develop optimal technique of cardiac multidetector computed tomography (MDCT) before noninvasive cardiac mapping before cateter ablation of atrial fibrillation.Materials and methods.94 patients with atrial fibrillation were included in study (60 males, 34 females; mean age = 58.3 ± 10 years; mean body mass index (BMI) = 29.9 ± ± 4.8). The patients were divided into 2 groups: I – 80 patients who underwent computer tomography (CT)-protocol for noninvasive cardiac mapping with standard contrast enhancement (single-bolus protocol); II – 14 patients who underwent CT with modified contrast enhancement technique with preliminary contrast injection (prebolus). To detect thrombotic masses in the left auricle the low-dose delayed phase was performed. The analysis of individual features of pulmonary veins, left atrium and adjacent structures was performed. Contrast enhancement of heart chambers was assessed by mean attenuation and homogeneity measurement.Results and discussion.The typical anatomy of the right pulmonary veins was in 93.6% of cases; right middle pulmonary vein in 5.3%; right segmental veins in 1.1%. The typical anatomy at the left side was in 57.4% of cases; common vestibulum of the left pulmonary veins in 18.1%; common left trunk in 24.5%. Volume enlargement of the left atrium (LA) was in 96.8% of patients. In 6 cases left auricle thrombosis was suspected, low-dose delayed phase was performed. In 2 cases filling defects in left auricle persisted, thrombosis was proved by transesophageal echocardiography. With the single-bolus injection protocol the contrast enhancement of left heart chambers was best (mean attenuation of blood in LA = 296 ± 84 HU, in left ventricle (LV) = 286 ± 83 HU), but the contrast enhancement and homogeneity of the chambers were insufficient (mean attenuation of blood in right atrium (RA) = 179 ± 97 HU, in right ventricle (RV) = 176 ± 80 HU). With prebolus protocol the contrast enhancement and homogeneity of all chambers were optimal (mean attenuation of blood in LA = 259 ± 31 HU, in LV = 286 ± 83 HU, in RA = 270 ± 92 HU, in RV = 253 ± 80 HU). This allowed making more accurate epi-endocardial heart models in the noninvasive cardiac mapping and operation planning.Conclusion.MDCT with standard contrast enhancement protocol provides detailed information about anatomy and size of pulmonary veins, the left atrium volume, the presence of intracardiac masses (including thrombotic masses), the anatomy of adjacent structures. The modified contrast enhancement technique with preliminary contrast injection (prebolus) allows to receive optimal contrast enhancement of all heart chambers and to make high accurate epi-endocardial models of both the right and left sides of the heart in case of noninvasive cardiac mapping.

scholarly journals Atypical size and location of a right atrial myxoma: a case report

2017 ◽  
Vol 4 (6) ◽  
pp. 2073
Author(s):  
Sushil Kumar Singhal ◽  
Palash Aiyer ◽  
Vijay Grover ◽  
Vijay Kumar Gupta
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Left Atrium ◽  
Right Atrium ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Right Atrial Myxoma ◽  
Intracardiac Tumors ◽  
The Right ◽  
Uncommon Location

Primary intracardiac tumors are rare and approximately 50-55% are myxomas. The majority of myxomas are located in the left atrium. Here We report a case of a large myxoma in the right atrium, which is an uncommon location for this type of tumor who underwent operative intervention with excision of a 9x6 cm multilobulated mass. In this case report, we emphasize the rarity of large myxomas in the right atrium and the difficulty of differential diagnosis given their dimension and location.

The modified Fontan operation in hearts associated with atrioventricular valvar atresia or common atrioventricular valve—neoseptation of the atriums using a right atrial flap

1994 ◽  
Vol 4 (4) ◽  
pp. 353-357 ◽  
Author(s):  
Tayyar Sarioglu ◽  
Tufan Paker ◽  
Halil Türkoglu ◽  
Atif Akçevin ◽  
Ayse Sarioglu ◽  
...  
Keyword(s):  
Left Atrium ◽  
Right Atrium ◽  
Fontan Operation ◽  
Right Atrial ◽  
Moderate Hypothermia ◽  
Atrioventricular Valve ◽  
Venous Flow ◽  
The Right ◽  
Modified Fontan Operation ◽  
Common Atrioventricular Valve

SummarySummary Between June 1988 and December 1992, six patients with dominant left and rudimentary right ventricles underwent orthoterminal correction with a modified Fontan operation in which the atriums were neoseptated using a flap constructed from the right atrial wali. Four patients had anomalous systemic venous connections. The operations were performed under direct caval cannulation, standard cardiopulmonary bypass, moderate hypothermia and cardioplegic arrest. After opening the right atrium with a longitudinal incision, the atrial septum was completely resected and the coronary sinus was cut back. The upper wall of the right atrial incision was brought down in such a way that the pulmonary venous atrium was drained into the dominant ventricle via the right-sided or common atrioventricular valve. This was followed by direct connection of the right atrium with its anterior wall reconstructed with pericardium to the pulmonary arteries. In one patient, a left superior caval vein draining to the left atrium was divided and anastomosed to left pulmonary artery. One patient died on the 12th postoperative day with pulmonary infection and sepsis, though he had no hemodynamic problem, and another died on the sixth day due to high pulmonary vascular resistance. The remaining four patients are progressing well at a mean of 23.4 months postoperatively with functional capacity of NYHA I-IT and sinus rhythm. Echocardiographic and angiocardiographic examinations during follow-up showed unobstructed pulmonary and systemic venous pathways in all. This modification of the Fontan operation seems a good alternative technique which creates a contractile left atrium with large enough dimensions and an unobstructed pathway for pulmonary venous flow.

Nonreentrant focal activations in pulmonary veins in canine model of sustained atrial fibrillation

2002 ◽  
Vol 283 (3) ◽  
pp. H1244-H1252 ◽  
Author(s):  
Shengmei Zhou ◽  
Che-Ming Chang ◽  
Tsu-Juey Wu ◽  
Yasushi Miyauchi ◽  
Yuji Okuyama ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Right Atrium ◽  
Cycle Length ◽  
Pulmonary Veins ◽  
Posterior Wall ◽  
Canine Model ◽  
Anterior Wall ◽  
High Density ◽  
The Right

Repetitive rapid activities are present in the pulmonary veins (PVs) in dogs with pacing-induced sustained atrial fibrillation (AF). The mechanisms are unclear. We induced sustained (>48 h) AF by rapidly pacing the left atrium (LA) in six dogs. High-density computerized mapping was done in the PVs and atria. Results show repetitive focal activations in all dogs and in 12 of 18 mapped PVs. Activation originated from the middle of the PV and then propagated to the LA and distal PV with conduction blocks. The right atrium (RA) was usually activated by a single large wavefront. Mean AF cycle length in the PVs (left superior, 82 ± 6 ms; left inferior, 83 ± 6 ms; right inferior, 83 ± 4 ms) and LA posterior wall (87 ± 5 ms) were significantly ( P < 0.05) shorter than those in the LA anterior wall (92 ± 4 ms) and RA (107 ± 5 ms). PVs in normal dogs did not have focal activations during induced AF. No reentrant wavefronts were demonstrated in the PVs. We conclude that nonreentrant focal activations are present in the PVs in a canine model of pacing-induced sustained AF.

scholarly journals P1703 Cardiac metastasis of germ cell tumor "like beads" in the right heart chambers and also left atrium

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Akturk ◽  
T S Tan ◽  
A Mammadli ◽  
M Mammadov ◽  
I Dincer ◽  
...  
Keyword(s):  
Germ Cell ◽  
Left Atrium ◽  
Germ Cell Tumor ◽  
Right Atrium ◽  
Germ Cell Tumors ◽  
Vena Cava ◽  
Cell Tumor ◽  
Right Atrial ◽  
Mobile Mass ◽  
The Right

Abstract Introduction Testis tumors constitute 1-2% of all malignant tumors in men. But it is the most common solid tumor in men between 15-35 years of age. Germ cell tumors constitute for almost 90% of all testis tumors. Intracardiac metastasis of testicular carcinomas is rare. We now report a case of a testicular germ cell tumor with right atrial metastasis. Case report A 30-year-old male patient was diagnosed with B-cell ALL.Chemotherapy and radiotherapy were completed in 2016. In January 2017, the patient applied to the hospital with pain in the right testicle.A mass detected and orchiectomy was performed.Pathologic examination revealed mixed germ cell tumor and B-cell ALL infiltration.Chemotherapy was started. The patient was admitted to our hospital with fever, in March 2018.Antibiotics were started but fever contuniued.Transthoracic echocardiography showed a large,hypoechogen,mobile mass in the right atrium.Then transesophageal echocardiography revealed a 2x3,3 cm mobile mass within the right atrium that prolapsed through the tricuspid valve into the right ventricle in diastole.We could not distinguish if it is a vegetation or a metastatic mass. The patient underwent cardiac surgery.Pathologic examination revealed mixed germ cell tumor metastasis. After the surgery, the patient was transferred to the intensive care unit because of sepsis. Antibiotics were expanded due to fever. Control transthoracic echocardiography and also transesophageal echocardiography showed a 1,8 x 0,6 cm mobile mass extending from the inferior vena cava into the right atrium and through the patent foramen ovale into the left atrium. One week after the surgery, a mass was detected in the transthoracic echocardiography. But no further examination was done. We thought that the mass may not have been completely removed in the the operation (residual tumor?). The patient was evaluated with the department of oncology and cardiovascular surgery. It was decided that reoperation would be very risky. Conclusion Metastatic tumors of the heart are seen more frequently than primary tumors. Although intracardiac metastasis of testicular germ cell tumors are rare (less than %1), it has been related to short survival. They may lead to the congestive heart failure, paradoxical systemic emboli and vena cava superior syndrome. Most cases in the literature are associated with right atrial mass. But in our case, the mass was extending from the inferior vena cava into the right atrium and through the patent foramen ovale into the left atrium. We wanted to share our experience and also wanted to discuss the treatment modality for similar patients. Abstract P1703 Figure.

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