scholarly journals Surgical treatment of thromboembolia in the heart right atrium in pregnant women

2021 ◽  
pp. 50-57
Author(s):  
I. V. Abdulyanov ◽  
M. R. Gaisin ◽  
R. K. Dzhordzhikiya ◽  
E. O. Sokolova ◽  
R. N. Khairullin
Keyword(s):  
Surgical Treatment ◽  
Pregnant Women ◽  
Right Atrium ◽  
Late Pregnancy ◽  
Routine Examination ◽  
Right Heart ◽  
Thrombus Removal ◽  
The Right ◽  
Working Heart ◽  
Clinical Cases

Two clinical cases of surgical treatment of cardiac right-chamber thromboembolism in pregnant women are described. Thromboembolism was diagnosed during a routine examination. In the first clinical case, considering the late pregnancy, a thromboembolectomy was performed under artificial circulation after surgical delivery.In the second case, thrombus removal from the right atrium was performed on a working heart, without interruption of pregnancy. The surgical and postsurgical period proceeded without any specific features and the patients were discharged from the hospital without any complications. These clinical cases show that it is possible to remove thrombus from the right heart chambers without the use of extracorporeal circulation, which is also safe for the mother and the fetus.

Successful surgical treatment of a giant coronary aneurysm communicating with the right atrium

2007 ◽  
Vol 8 (12) ◽  
pp. 1061-1064 ◽  
Author(s):  
Andrea Rognoni ◽  
Valeria Ferrero ◽  
Giovanni Teodori ◽  
Flavio Ribichini
Keyword(s):  
Surgical Treatment ◽  
Right Atrium ◽  
Coronary Aneurysm ◽  
Giant Coronary Aneurysm ◽  
The Right

SUCCESSFUL SURGICAL TREATMENT OF THROMBOSIS OF THE RIGHT ATRIUM IN A CHILD WITH STEROID-RESISTANT NEPHROTIC SYNDROME

2018 ◽  
Vol 13 (3) ◽  
pp. 145-146
Author(s):  
M.A. MARTAKOV ◽  
E.M. ZAJNETDINOV ◽  
V.P. PRONINA ◽  
N.V. SHESTERIKOV ◽  
V.V. SHESTERIKOVA ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Surgical Treatment ◽  
Right Atrium ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
The Right

scholarly journals The study of systemic hemodynamic disorders of patients with varicose and post-thrombotic diseases

2020 ◽  
Vol 19 (2) ◽  
pp. 32-37
Author(s):  
I. N. Shanaev
Keyword(s):  
Blood Flow ◽  
Right Ventricle ◽  
Right Atrium ◽  
Ultrasound Examination ◽  
Anterior Wall ◽  
Right Heart ◽  
Normal Limits ◽  
Flow Through ◽  
The Right ◽  
Restrictive Type

Aim. Study of heart function in the patients with CVD. Materials and methods. 46 patients with varicosity (VD) and 34 patients with post-thrombotic disease (PTD) were examined; the control group was represented by 15 healthy volunteers. The diagnosis was established using the CEAP basic classification. The study did not include patients with a diagnosed arterial hypertension, diabetes mellitus, chronic lung disease, significant hemodynamic heart defects, coronary heart disease. Ultrasound examination of the heart and veins of the lower extremities was performed on a Saote My Lab Alpha, Acuson Sequoia 512 apparatus. In addition to the standard protocol of heart ultrasound examination, the parameters of the right heart were calculated: sizes of the right ventricle (RV), right atrium, thickness of the anterior wall of the pancreas; to assess the ejection fraction (EF) of the pancreas the mobility of the lateral edge of the tricuspid ring was calculated, and the pressure on the tricuspid valve (TV) was measured. Diastolic ventricular function was studied by spectrograms of tricuspid and mitral blood flow. Results. Most of the indicators of cardiac activity in patients with VD were within normal limits, but a tendency to increase increasing of the right heart size was noted. In addition, the thickness of the interventricular septum and the right ventricle (RV) anterior wall was found to increase from 0.8 to 1.1 cm and from 0.3 to 0.5 cm, respectively, according clinical classes from C2 to C6 (CEAP). Eject fraction (EF) of both the RV and the left ventricle (LV) were also within normal limits, but with a tendency to decrease (67.8 % – C2, to 62 % – C6). The growth of the clinical class is followed by the increasing of percentage of non-restrictive blood flow through the tricuspid valve (TV). The restrictive type of blood flow in patients with VD had not been identified. Patients with PTD also showed a tendency to increase the right heart. However, whereas the size of the RV, as a rule, did not exceed 3.0 cm, the size of the right atrium was slightly higher than normal one in the clinical class C4 and C5.6. All the patients had EF of LV within normal limits, but it slightly decreased by the growth of class. Only patient classes C3 and C4 had EF of RV within the normal range. The 18 % of patient class C5.6 had EF lower than normal with value 48%. Diastolic dysfunction (DD) of the RV was detected in 73.3% of patients with class C3 and 100% with classes C4 and C5.6. Moreover, a restrictive type of blood flow through TV appeared from class C4 and the percentage increased up to 27.2% (class C5,6). Conclusions. DD of the RV was the main hemodynamic disorder.

scholarly journals Novel technique of repairing right partial anomalous pulmonary venous connection with intact atrial septum using in situ interatrial septum as a flap in a 68-year-old-woman: a case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Atsushi Morishita ◽  
Ikuo Hagino ◽  
Hideyuki Tomioka ◽  
Seiichiro Katahira ◽  
Takeshi Hoshino ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Atrium ◽  
Septal Defect ◽  
Surgical Repair ◽  
Interatrial Septum ◽  
Pulmonary Artery Hypertension ◽  
Right Heart ◽  
Intact Atrial Septum ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

Abstract Background Partial anomalous pulmonary venous connection draining into the right atrium with an intact atrial septum is a very rare clinical entity in the adult population. Partial anomalous pulmonary venous connection must be suspected as a differential diagnosis when the cause of right heart enlargement and pulmonary artery hypertension is unknown. Case presentation This study describes the surgical case of an isolated right partial anomalous pulmonary venous connection to the right atrium in a 68-year-old woman, who underwent tricuspid ring annuloplasty and right-sided maze procedure simultaneously. She had complaints of gradually progressing dyspnea on exertion. However, a diagnosis could not be established despite consultations at multiple hospitals for over a year. Right heart catheterization revealed severe pulmonary artery hypertension with a mean pulmonary artery pressure of 46 mmHg, step-up phenomenon of oxygen saturation at the mid-level of the right atrium with a pulmonary-to-systemic blood flow ratio of 2.4, and a pulmonary vascular resistance of 3.1 Wood Units. As medical treatment with pulmonary artery vasodilator therapy did not improve her symptoms, she underwent surgical repair. An atrial septal defect was created surgically with a curvilinear tongue-shaped cut. The right anomalous pulmonary veins were rerouted through the surgically created atrial septal defect into the left atrium with a baffle comprised of the interatrial septum flap, kept in continuity with the anterior margin and sutured while mobilizing the enlarged right atrium. The patient had an uneventful postoperative course and remains asymptomatic. Conclusions The described surgical technique could be considered an effective alternative for patients undergoing surgical repair for a partial anomalous pulmonary venous connection isolated to the right atrium. The indication for surgery must be judged on a case-by-case basis in these patients with prevalent systemic-to-pulmonary shunting.

scholarly journals P689 Surgical treatment of a right heart thrombus-in-transit with massive bilateral pulmonary embolism

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C M Angelescu ◽  
I Hantulie ◽  
Z Galajda ◽  
I Mocanu ◽  
A T Paduraru ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Right Atrium ◽  
Intracardiac Thrombus ◽  
Severe Pulmonary Hypertension ◽  
Right Heart ◽  
Right Pulmonary Artery ◽  
The Right ◽  
In Transit ◽  
Right Heart Dysfunction

Abstract Introduction Right heart thrombi are rare, found in up to 20% of pulmonary emboli (PE), and associated with significantly increased mortality(1). A thrombus entrapped in a PFO is a rare form of right heart thromboembolism. Clinical Case A 73-year-old male patient who had dyspnea for 10 days, was transferred to our hospital for the surgical treatment of a cardiac tumor. We performed TTE which revealed a free floating, huge mass( measuring more than 8 cm long) in the right atrium, that protruded in the right ventricle, with high risk of embolization. Another smaller mass, attached to the interatrial septum. Severe right ventricular dysfunction and severe pulmonary hypertension were present. Contrast-enhanced computer tomography was performed, which revealed severe bilateral pulmonary artery emboli with complete occlusion of right pulmonary artery branch. Clinical and paraclinical data strongly suggested that the huge cardiac mass was a thrombus that originated from the lower extremity veins. TEE showed that the thrombus was entrapped through the PFO, with a smaller part in the left atrium and the biggest portion in the right atrium. The patient underwent an emergent on-pump surgical cardiac and right pulmonary artery embolectomy. The right atrium was opened and a huge intracardiac thrombus with a lengh of 14 cm extending from the coronary sinus, to PFO in the left atrium and also in the right ventricle was removed. The right branch of the pulmonary artery was opened and a large volume of clot- 9 cm long- was removed. The patient was removed from cardio-pulmonary by-pass (CPB) on high doses of norepinephrine and dobutamine and necessitated initiation of venous-arterial ECMO to support the severe right heart dysfunction. He was extubated after 10 days, with little improvement in the clinical status. Transthoracic echocardiography showed smaller right heart cavities), normal left ventricular function, but persistent severe RV dysfunction and severe pulmonary hypertension. In the thirteenth postoperative day, he installed cardio-respiratory arrest and he died. Discussion In this report we describe a case of a patient with a huge intracardiac thrombus, entrapped through a PFO, associated with massive pulmonary embolism, with late presentation in our hospital and severe refractory right heart dysfunction. He underwent successful embolectomy, which is a unique procedure in the treatment of an acute pulmonary embolism and entrapped thrombus in a PFO. Conclusion The treatment of choice for emboli-in-transit is controversial. In a recent review, surgical thromboembolectomy showed a trend toward improved survival and significantly reduced systemic emboli compared to anticoagulation. Thrombolysis in these patients may cause fragmentation of thrombus and systemic embolization, resulting in increased mortality. Management decisions should be made with multidisciplinary coordination and consideration of complicating factors such as PFO. Abstract P689 Figure. Extensive biatrial thrombus

Idiopathic dilatation of the right atrium: a rare cause of right heart failure

2019 ◽  
Vol 27 (8) ◽  
pp. 713-714 ◽  
Author(s):  
Surender Deora ◽  
Alok Kumar Sharma ◽  
Pawan Garg
Keyword(s):  
Heart Failure ◽  
Right Atrium ◽  
Right Heart Failure ◽  
Right Heart ◽  
The Right

scholarly journals The importance of intraoperative transoesophageal monitoring when operating on renal cancers that involve the right atrium

2014 ◽  
Vol 96 (6) ◽  
pp. e18-e19 ◽  
Author(s):  
J George ◽  
K Grebenik ◽  
N Patel ◽  
D Cranston ◽  
S Westaby
Keyword(s):  
Renal Cell Carcinoma ◽  
Surgical Treatment ◽  
Cell Carcinoma ◽  
Right Atrium ◽  
Renal Cell ◽  
Transoesophageal Echocardiography ◽  
Cardiac Monitoring ◽  
Vascular Involvement ◽  
Tumour Thrombus ◽  
The Right

The surgical treatment of advanced renal cancers is challenging. Renal cell carcinoma is interesting in that it invades the vasculature and can extend up as far as the right atrium. Extension of tumour thrombus into the right atrium represents level IV disease, according to Robson staging. Transoesophageal echocardiography is useful for diagnostic purposes. It is also of great value for intraoperative cardiac monitoring and to confirm the extent of vascular involvement.

scholarly journals Right Heart Failure Due to Secondary Chondrosarcoma in the Right Atrium

2020 ◽  
Vol 13 (4) ◽  
Author(s):  
Michael Haslinger ◽  
Christian Dinges ◽  
Marcel Granitz ◽  
Eckhard Klieser ◽  
Uta C. Hoppe ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Atrium ◽  
Right Heart Failure ◽  
Right Heart ◽  
Secondary Chondrosarcoma ◽  
The Right

scholarly journals P234 Giant right atrial myxoma presenting as right heart failure

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
G Carazo Vargas ◽  
J A Fuentes Mendoza ◽  
M E Ruiz Esparza
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Right Atrium ◽  
Clinical Case ◽  
Right Ventricular Outflow Tract ◽  
Right Heart Failure ◽  
Ventricular Outflow Tract ◽  
Atrial Myxoma ◽  
Right Heart ◽  
The Right

Abstract Introduction Myxomas are the most frequent primary cardiac neoplasms. It is currently believed that myxomas are derived from multipotent mesenchymal cells capable of both neural and epithelial differentiation Histologically, these tumors are composed of dispersed cells within a stroma of mucopolysaccharides Myxomas produce vascular endothelial growth factor, which probably contributes to the growth induction at the initial stages of tumor growth. Tumors vary widely in size, ranging from 1 to 15 cm in diameter and weighing between 15 and 180 g. About 35 percent of myxomas are friable, and they tend to present emboli. The clinical characteristics of these tumors are closely related to their location, size, and mobility; there are no specific signs and symptoms that suggest the presence of a myxoma. There are several mechanisms by which cardiac tumors can cause symptoms. The blockage of circulation through the heart or heart valves produces symptoms of heart failure. Atrial myxoma can interfere with the valves of the heart and cause regurgitation. They can also produce systemic embolisms and constitutional signs. Clinical Case We present a 29-year-old female patient who started with fatigue, weight loss, increased abdominal perimeter and dyspnea of one month"s effort that progressed to dyspnea at rest in the last week associated with syncope, so she decided to go to the emergency department of our institution. Upon arrival at the emergency room, the patient was found with vital signs within normal parameters, however with dyspnea at rest, jugular plethora and important lower limb edema. On auscultation, a systolic-diastolic murmur was found with an increase in the Rivero Carvallo maneuver, with reinforcement of the pulmonary component of the second noise and parasternal high-left rise. In clinical analysis, NT-proBNP 5698pg/mL, AST 34, INR 1.65 and serum lactate of 4.2 was found. A Transthoracic Echocardiogram (TTE) was performed, where a 10cm mass effusion was documented that occupied the entire right atrium and protruded into the right ventricular outflow tract. With these findings, medical treatment was started for right heart failure and it was to cardiac surgery for resection of the right atrium where it had been performed, however during the immediate postoperative state, presented biventricular failure and later asystole without achieving a return of spontaneous circulation despite resuscitation maneuvers. Conclusion In this case, it is an unusual presentation of a rare cardiac pathology that started with symptoms of right heart failure due to the obstruction of the right ventricular outflow tract. We consider that it is an interesting clinical case and with important educational aspects to take into consideration the differential clinical diagnoses of a patient presenting to the emergency department with right heart failure. Abstract P234 Figure. Giant Myxoma

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