Aortic Valve Myxoma Mimicking Vegetation: Report of a Case

We report a case of cardiac myxoma of the aortic valve. To our knowledge, this represents only the seventh such case ever documented. A 61-year-old woman underwent an echocardiography to screen for hypertensive–diabetic cardiac complications, which showed a mass on her aortic valve. Although she had not experienced a fever, the mass closely resembled a vegetation, resulting in an initial diagnosis of infective endocarditis. We extirpated the mass and repaired the aortic valve with the patient under cardiopulmonary bypass. The postoperative course was uneventful. Histological examination confirmed that the mass was a myxoma.     

Aortic Valve Myxoma

The authors report a case of aortic valve myxoma discovered in a 34-year-old patient who had suffered a transient ischemic attack. At operation, a heliocoidal gelatinous mass was found attached to the ventricular side of the right coronary cusp of the aortic valve via a pedicle. Through a ministernotomy approach the mass was excised and the cusp was repaired. Recovery was uneventful.     

Bicuspid aortic valve endocarditis complicated by mitral valve aneurysm

We describe a case of mitral valve aneurysm associated with concomitant aortic valve endocarditis. Aneurysms appear as a localized saccular bulge of the anterior leaflet into the left atrium and thus are often misdiagnosed as mitral valve prolapse, myxomatous mitral valve, or atrial myxoma. The presentation and management of mitral valve aneurysms are the subject of this case report.     

Familial cardiac myxoma: emphasis on unusual clinical manifestations.

This report describes familial cardiac myxoma involving parent and child. The familial occurrence of this condition, previously reported in four other families, underscores the necessity of screening all direct members of the family by echocardiography once the diagnosis of cardiac myxoma is made. Each patient presented with unusual clinical manifestations. The father, who had a right atrial myxoma associated with an atrial septal defect and mitral valve prolapse, presented with findings highly suggestive of paradoxical embolism. The daughter, who had an infected right ventricular myxoma, was initially treated for valvular subacute bacterial endocarditis before the diagnosis was made.     

Combined operation for left atrial myxoma, mitral regurgitation, coronary artery stenosis and abdominal aortic aneurysm

A 68-year-old male patient with a left atrial myxoma, mitral regurgitation, ischemic heart disease and abdominal aortic aneurysm underwent resection of the myxoma, mitral valve replacement, 4 coronary artery bypass grafting and replacement of the aneurysm simultaneously. The aneurysm was replaced under partial cardiopulmonary bypass. Combined cardiac and abdominal aortic operation is useful in selected patients who require IABP support postoperatively or whose cardiac function is poor.     

Repair of Aortico–Left Ventricular Tunnel Originating From the Left Aortic Sinus

We report on a case of an 11-year-old asymptomatic child with aortico–left ventricular tunnel arising from the left aortic sinus. Preoperative transesophageal echocardiography showed a dilated aortic root with mild aortic valve incompetence and demonstrated the course of the tunnel, which originated from the left coronary sinus entering the outlet portion of the left ventricular outflow tract. Patch closure of the aortic end of the tunnel eliminated left ventricular volume overload with immediate marked reduction of cardiomegaly. At 10-month follow-up the child is asymptomatic and receiving no oral medications. Control two-dimensional Doppler echocardiography shows trivial central aortic valve incompetence.     

Unusually large left atrial myxoma causing mitral valve occlusion and hiding a severe mitral regurgitation: a case report

We report a case of a 68-year-old woman with a large left atrial myxoma occluding the mitral valve. The tumor was diagnosed by preoperative echocardiogram. During the operation and after the myxoma resection, a severe mitral valve regurgitation, which was not observed during the preoperative echocardiogram, was noticed. Mitral valve defect was corrected by an annuloplasty ring, and the patient had an uneventful recovery. Careful evaluation of the mitral valve during a myxoma resection operation is recommended.     

Tricuspid valve myxoma: a rare indication for tricuspid valve repair.

Excision of a myxoma involving the tricuspid valve often necessitates tricuspid valve replacement or a less than optimal margin of resection. We report a successful tricuspid valve repair after en bloc resection of a myxoma involving the septal leaflet of the tricuspid valve.     

Emergent David-V operation for a ruptured aortic root aneurysm in a 9-year-old child.

Ruptured aortic root aneurysm is very rare in children less than 10 years of age. Isolated dilatation of the ascending aorta and/or aortic root in a child is mostly associated with Marfan's syndrome, and the standard surgical treatment is aortic root replacement with a composite valve graft or homograft. We report here a successful emergent T. David-V operation using two grafts of different sizes for a ruptured aortic root aneurysm in a 9-year-old child with Marfan's syndrome.     

Robotic excision of atrial myxoma

Abstract Background: Advances in optics and instrumentation with the da Vinci S Surgical System have facilitated minimally invasive and robotic cardiac procedures including mitral valve repair and atrial myxoma excision. We report our retrospective data comparing robotically assisted myxoma excision with standard median sternotomy excision. Methods: Data were collected for cardiac myxoma resection performed between January 2000 and December 2009. The resulting cohort included a total of 57 patients. These patients were grouped into two categories: robotic‐assisted (n = 17) surgical procedures and traditional (nonrobotic; n = 40) surgical procedures. Presurgical and surgical risk factors were examined. Results: Univariate analysis comparing the surgical procedure groups and surgical risk factors found a significant difference in 3 of the 14 variables. Cannulation in all patients undergoing robotic‐assisted cardiac myxoma excision was performed through cannulating the common femoral artery and vein while cannulation for the traditional procedures was performed using the aorta and atrium except for two patients. For aortic occlusion, 14 of the robotic‐assisted cardiac myxoma patients had balloon occlusion and 34 of the traditional cardiac myxoma patients had aortic cross‐clamp occlusion. Operating time was significantly shorter for robotic cases (2.7 hours) compared with traditional cases (3.5 hours). Conclusion: Robotic excision of atrial myxomas is safe and may be an alternative to traditional open surgery in selected patients. (J Card Surg 2012;27:423‐426)     

Aortic valve replacement with extracorporeal circulation in a pregnant woman. Apropos of a case

The authors report a case of surgical treatment of aortic stenosis in a pregnant woman (first pregnancy after four years treatment of sterility). The aortic valve replacement was performed at 16 weeks of amenorrhea. The valve was replaced by an Ionescu-Shiley bioprosthesis. Delivery was performed by caesarean section after 39 weeks of amenorrhea. There was no complication either for the mother or the child. Review of the literature allows analysis of the influence of aortic stenosis on pregnancy, and of the pregnancy on the tolerance of aortic stenosis. Some aspects of cardiopulmonary bypass for valve replacement in pregnant women are also analysed.     

Bile Duct Injury during Laparoscopic Cholecystectomy: Risk Factors,Mechanisms, Type,Severity and Immediate Detection

34-year-old male with history of recurrent atrial fibrillation (AF) and mitral stenosis, status post radio-frequency ablation (RFA) and prosthetic mitral valve replacement two years earlier was admitted with prosthetic valve thrombosis for redo mitral valve surgery. During the surgery, a 2 χ 1.5 χ 1 cm mass was identified on the interatrial septum, attached to the edge of tricuspid valve’s septal leaflet by a stalk. The mass was excised and histological evaluation revealed myxoma. It is accepted that myxomas can develop after cardiac trauma. It is known that RFA for AF increases the risk of thrombus or endocarditis in the atrium. Herein, we report a myxoma case where we think the heat energy caused by RFA might have triggered the development of the tumor.     

Multiple cardiac myxomas with multiple recurrences: unusual presentation of a "benign" tumor

A 20-year-old woman with a two-week history of palpitations and constitutional symptoms was found to have right atrial and left ventricular myxomas. The myxomas were excised, but the patient had two recurrences of the tumor in the left atrium four and a half years after the initial presentation. The recurrent myxoma was locally aggressive, and removal required excision of the aortic valve. This patient demonstrates the need for careful follow-up for recurrences of myxoma.     

Myxoma involving the atrial valve chordae

Primary cardiac valve tumors are rare and comprise less than 10% of all cardiac tumors. They are, however, of clinical importance because of their unique locations. We report an unusual case of myxoma involving the tricuspid valve chordae in a young woman presenting with syncope. The myxoma was diagnosed by echocardiography and successfully removed by excision of the involved tricuspid valve chordae with valve preservation. (Curr Surg 57:357-358)     

Heterogeneous Double Cardiac Tumor: Myxoma Concomitant with Papillary Fibroelastoma

Abstract   Heterogeneous double cardiac tumor is rarely encountered. We present a case of simultaneous resection of myxoma and papillary fibroelastoma. Transesophageal echocardiography showed typical characteristics of each tumor. The myxoma was completely excised with a surgical margin, and the papillary fibroelastoma was shaved, preserving the cusp of the aortic valve. Pathohistologic examination confirmed the diagnosis. We discuss the echocardiographic characteristics and preferred surgical approaches for the two tumors. (J Card Surg 2010;25:35-37)     

Right ventricular myxoma: Report of a case

We herein report a 36-year-old man who underwent surgical resection for myxoma. Preoperative two-dimensional echocardiography demonstrated a mass in the right ventricle. Intraoperatively, the tumor was found to derive from an anterior papillary muscle of the tricuspid valve. The tumor was successfully excised and the tricuspid valve was repaired with chordoplasty and annuloplasty. A histopathological examination revealed myxoma and a 2-year follow-up has shown no evidence of recurrence or tricuspid valve regurgitation.     

Surgical management of left coronary artery ostial atresia and supravalvar aortic stenosis.

Congenital atresia of the left main coronary artery ostium is a rare lesion, particularly when found in association with supravalvar aortic stenosis. This report describes the preoperative evaluation and surgical management of this lesion found in conjunction with a quadricuspid aortic valve in a 5-year-old child. Patch aortoplasty and left internal thoracic artery to left anterior descending coronary artery bypass were performed to correct this lesion.     

Cardiac Wegener's granulomatosis masquerading as left atrial myxoma

A 56-year-old woman was referred with mitral regurgitation, left ventricular dysfunction, and a sessile mass on the anterior leaflet of her mitral valve. The initial impression from echocardiography was that she had a left atrial myxoma. At operation, we found an intense inflammatory process diagnosed as Wegener's granulomatosis. It also involved the aortic valve and contiguous myocardium.     

Aarskog syndrome with aortic root dilatation and sub-valvular aortic stenosis: surgical management

Aarskog syndrome is a familial condition associated with craniofacial anomalies, genital malformations and short stature. Affected children have significantly higher chance of having congenital heart disease (CHD) than the general population. We report the case of a child afflicted with progressive aortic root dilatation and sub-valvular aortic stenosis, successfully managed with aortic root and valve replacement. Given the association between Aarskog syndrome and CHD, cardiac surveillance should be undertaken in all affected children.     

Ascending-Descending Aortic Bypass for the Treatment of Concomitant Severe Co-arctation,Aortic Valve Disease and Hypoplastic Aortic Arch

This report describes a one-stage treatment of a 30-year-old patient suffering from severe aortic valve insufficiency, aortic co-arctation, dilatation of the ascending aorta and arcus hypoplasia. The patient underwent aortic valve, ascending aorta and arch replacement through median sternotomy. The aorta was ligated at the level of the co-arctation, which was located in the proximal part of the descending aorta, and an ascending-descending bypass was created using a transhiatic approach. The postoperative course was complicated by a cerebrovascular accident.