scholarly journals Decompensated Aortic Stenosis in a Young Patient with Multiple Comorbidities - A Case Report

2020 ◽  
Vol 25 (2) ◽  
pp. 39-41
Author(s):  
Alexandra Stoica ◽  
Marius Harpa ◽  
Hussam Al Hussein ◽  
Carmen Opriş ◽  
Cosmin Opriş ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Left Atrial ◽  
Systolic Function ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Atrial Myxoma ◽  
Rapid Progression ◽  
Left Atrial Myxoma ◽  
Aortic Pathology

AbstractAortic valve replacement is a safe therapy that can reverse cardiac remodeling and increase cardiac contractility, improve symptoms and quality of life. We presented a case of a 35-year-old male patient admitted to the Emergency Institute for Cardiovascular Disease and Transplantation of Târgu Mureș, Romania, due to severe aortic stenosis with severely depressed ejection fraction, left atrial myxome and a history of deep vein thrombosis and pulmonary thromboembolism. He underwent excision of the aortic valve and replacement with a mechanical prosthesis, excision of left atrial myxoma and tricuspid annuloplasty. The postoperative evolution was favourable with a significant recovery of the left ventricular systolic function and regression of cardiac symptomatology. This case was particular due to the rapid progression of the aortic pathology with the reduction of cardiac (systolic) function in a relatively short time as well as the occurrence of the thromboembolic event unrelated to the left atrial myxoma and rather associated with the background of cardiac failure with low cardiac output.

scholarly journals Effect of persistence of left ventricular hypertrophy and left atrial dilatation after aortic valve replacement on early outcomes and survival: a prospective study

2019 ◽  
Vol 6 (10) ◽  
pp. 3786
Author(s):  
Hari Krishna Murthy P. ◽  
Abha Chandra
Keyword(s):  
Aortic Valve ◽  
Left Ventricular Hypertrophy ◽  
Aortic Stenosis ◽  
Left Atrial ◽  
Ventricular Hypertrophy ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Significant Difference ◽  
A Prospective Study

Background: The objective of the study was to evaluate the early outcomes and survival in patients with severe aortic stenosis associated with concentric left ventricular hypertrophy following aortic valve replacement.Methods: This is a prospective study done at SVIMS, Tirupati, from June 2014 to September 2015 evaluating out comes and survival in patients undergoing primary isolated aortic valve replacement (AVR) for severe aortic stenosis, severe aortic stenosis with mild aortic regurgitation and severe aortic stenosis with moderate aortic regurgitation.Results: A total of 40 cases 26 males and 14 females aged 18 to 60 years (mean age, 48.5±13.4 years) underwent elective AVR. Left ventricular end diastolic diameter (p=0.008) at 6 months, a statistically highly significant difference in left ventricular mass  preoperatively, at discharge, at 3rd and 6th month follow up. The difference in mean left ventricular mass index (LVMI) had declined from 244.425 to 141.100 at 6 months, showing a statistically highly significant difference in LVMI preop, at discharge, at 3rd month and at 6th month follow up.Conclusions: Patients with preoperative increase in LVMI, with large left atrial diameter carries a strong predictor of postoperative mortality for patients undergoing aortic valve surgery. We also conclude that there will be significant regression of LVMI following successful AVR. But, the decrease in LVMI is maximum during early three months and it is minimal though significant in the later course of follow up. 

Abstract 11154: Predictors of Improvement of Left Ventricular Diastolic Function After Transcatheter Aortic Valve Replacement in Severe Aortic Stenosis With Preserved Left Ventricular Systolic Function: A Serial Echocardiographic Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Hiroto Utsunomiya ◽  
Hirotsugu Mihara ◽  
Yuji Itabashi ◽  
Javier Berdejo ◽  
Ken Matsuoka ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Diastolic Function ◽  
Transcatheter Aortic Valve Replacement ◽  
Systolic Function ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Transcatheter Aortic Valve ◽  
Valve Area

Background: Improvement of left ventricular (LV) diastolic function (DF) after transcatheter aortic valve replacement (TAVR) is not fully elucidated. The present serial transthoracic echocardiography study aimed to investigate the long-term clinical and hemodynamic impact of DF improvement after TAVR and to identify its predictors. Methods: We retrospectively reviewed echocardiographic and clinical data before and after TAVR in 98 patients with severe aortic stenosis (AS) and preserved LV systolic function. Mitral annular displacement was measured as the maximal distance of lateral annular motion during systole in apical 4-chamber view. DF was classified as grade 0 to 3 based on the recommendations of the American Society of Echocardiography. DF improvement was defined as ≥1 grade improvement at the 1-year follow-up. Results: Fifty-nine patients (60%) showed DF improvement. At baseline, patients with the improvement had a less severity of AS (valve area index, 0.37 ± 0.09 vs. 0.32 ± 0.08 cm2/m2) than those with no improvement. Despite similar baseline and changes in LV ejection fraction and mass index, the improvement group shows better recovery of functional status, stroke volume index, and E/e’ (Fig.1-3), as well as plasma brain natriuretic peptide level (median, 264 to 110 vs. 267 to 252 pg/ml, p = 0.017). When adjusting for age, demographic variables, valve area and change in mass index, absence of coronary artery disease (p = 0.03), mitral annular displacement (p < 0.001), and right ventricular end-diastolic diameter (p = 0.02) were independently associated with DF improvement. A mitral annular displacement >11.9 mm had a sensitivity of 83% and a specificity of 72% for prediction of DF improvement (Fig.4). Conclusion: DF improvement is often observed after TAVR and when present may be accompanied by more favorable clinical and hemodynamic changes. Mitral annular displacement, but not AS severity or degree of mass regression, predicts DF improvement after TAVR.

Coronary embolism of left atrial myxoma coexisting with severe aortic stenosis and atherosclerotic coronary disease

2016 ◽  
Vol 203 ◽  
pp. 315-316 ◽  
Author(s):  
María Teresa Nogales-Romo ◽  
Gabriela Tirado ◽  
Afonso Freitas-Ferraz ◽  
Pedro Martínez-Losas ◽  
José Luis Rodrigo ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Coronary Disease ◽  
Left Atrial ◽  
Severe Aortic Stenosis ◽  
Atrial Myxoma ◽  
Left Atrial Myxoma ◽  
Coronary Embolism

scholarly journals The First Manifestation of a Left Atrial Myxoma as a Consequence of Multiple Left Coronary Artery Embolisms

2017 ◽  
Vol 3 (3) ◽  
pp. 111-117
Author(s):  
Martin Novak ◽  
Petr Fila ◽  
Ota Hlinomaz ◽  
Vita Zampachova
Keyword(s):  
Coronary Artery ◽  
Left Atrial ◽  
Left Coronary Artery ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Atrial Myxoma ◽  
Foramen Ovale ◽  
Ventricular Systolic Function ◽  
Left Atrial Myxoma

AbstractA case of multiple embolisms in the left coronary artery as a rare first manifestation of left atrial myxoma is reported. A patient with embolic myocardial infarction and congestive heart failure was treated by percutaneous aspirations and balloon dilatations. Transesophageal echocardiography disclosed a villous myxoma with high embolic potential. Surgical resection of the tumour, suturing of a patent foramen ovale suture and an annuloplasty of the dilated tricuspid annulus was performed the third day after the admission. Recovery of the documented left ventricular systolic function can be explained by resorption of myxomatous material. The patient was discharged ten days after the surgery.

scholarly journals Cerebral embolism due to left atrial myxoma in a patient presenting with chest pain and ST-segment elevation: a case report

2020 ◽  
Author(s):  
António Fontes ◽  
Nuno Dias-Ferreira ◽  
Anabela Tavares ◽  
Fátima Neves
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Left Atrial ◽  
Left Ventricular ◽  
Atrial Myxoma ◽  
Left Atrial Myxoma ◽  
St Segment ◽  
Wide Range ◽  
St Elevation

Abstract Background Myocarditis is an uncommon, potentially life-threatening disease that presents with a wide range of symptoms. In acute myocarditis, chest pain (CP) may mimic typical angina and also be associated with electrocardiographic changes, including an elevation of the ST-segment. A large percentage (20–56%) of myxomas are found incidentally. Case summary A 62-year-old female presenting with sudden onset CP and infero-lateral ST-elevation in the electrocardiogram. The diagnosis of ST-elevation myocardial infarction was presumed and administered tenecteplase. The patient was immediately transported to a percutaneous coronary intervention centre. She complained of intermittent diplopia during transport and referred constitutional symptoms for the past 2 weeks. Coronary angiography showed normal arteries. The echocardiogram revealed moderate to severe left ventricular systolic dysfunction due to large areas of akinesia sparing most of the basal segments, and a mobile mass inside the left atrium attached to the septum. The cardiac magnetic resonance (CMR) suggested the diagnosis of myocarditis with concomitant left atrial myxoma. The patient underwent resection of the myxoma. Neurological evaluation was performed due to mild vertigo while walking and diplopia in extreme eye movements. The head magnetic resonance imaging identified multiple infracentimetric lesions throughout the cerebral parenchyma compatible with an embolization process caused by fragments of the tumour. Discussion Myocarditis can have various presentations may mimic acute myocardial infarction and CMR is critical to establish the diagnosis. Myxoma with embolic complications requires emergent surgery. To the best of our knowledge, this is the first case reported in the applicable literature of a myxoma diagnosed during a myocarditis episode.

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