Extracardiac Fontan Operation With Tube Fenestration Allowing Transcatheter Coil Occlusion (original) (raw)
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Novel Strategies for Recurrent Cardiac Myxoma
The Annals of Thoracic Surgery, 2008
Downloaded from 5. Cochran RP, Starkey TD, Panos AL, et al. Ambulatory intraaortic balloon pump use as bridge to heart transplant. Ann Thorac Surg 2002;74:746 -52. 6. Kantrowitz A, Krakauer J, Rubenfire M, et al. Initial clinical experience with a new permanent mechanical auxiliary ventricle: the dynamic aortic patch. Trans Am Soc Artif Int Organs 1972;18:159 -67. 7. Trainini J, Cabrera Fischer EI, Barisani J, et al. Dynamic aortomyoplasty in treating end-stage heart failure. J Heart Lung Transplant 2002;21:1068 -73. 8. Furman S, Whitman R, Stewart J, Parker B, McMullen M. Proximity to aortic valve and unidirectionality as prime factors in counterpulsation effectiveness. Trans Am Soc Artif Int Organs 1971;17:153-9. 9. Davies AN, Peters WS, Su T, et al. Extra-ascending aortic versus intra-descending aortic balloon counterpulsation: effect on coronary artery blood flow. Heart Lung Circ 2005;14: 178 -86. 10. Legget ME, Peters WP, Milsom P, et al. Extra-aortic balloon counterpulsation: an intraoperative feasibility study. Circulation 2005;112(Suppl I):26 -31. A 21-year-old man presented with a stroke. Subsequent investigations revealed cardiac tumors in his left atrium and right ventricle. These were removed by conventional techniques. Histopathology confirmed them as myxomas. He had a complete neurologic recovery, but presented 2 years later with recurrence of a cardiac myxoma in his left ventricle and left atrium. This time, however, endoscopically assisted techniques were used. The tumor was excised with supplementary cryoablation. The patient made a quick recovery from this second procedure and has had no recurrence after a 1-year follow-up. (Ann Thorac Surg 2008;85:2125-6)
Operative management of intracardiac myxomas: A single center experience
Medical Journal Armed Forces India, 2014
Background: Cardiac myxomas are the most common benign intracardiac tumors. We studied the clinical presentation of cardiac myxomas, their morbidity, mortality and recurrence rate following surgery at our institution over a period of four years. Methods: During August 2008 to November 2012, a total of 12023 cardiac surgeries were performed. Amongst these, 50 patients (12 males, 38 females) underwent complete removal of primary or recurrent intracardiac myxomas. Complete tumor excision with a cuff of interatrial septum followed copious saline irrigation of the cardiac chambers was performed in each case. Results: Forty six patients survived the surgery of which 43 are being followed up at regular intervals for development of recurrence. Myxomas constituted 0.41% of the total cardiac surgeries at our institute. Most of them were noted in the fourth decade. The commonest location was left atrium (74%) followed by right atrium (22%). Only one patient had a myxoma in the right ventricle. Forty six patients (92%) survived the surgery. Conclusion: Cardiac myxoma excision account for a very small percentage of cardiac procedures. Immediate surgical treatment is indicated in all patients. Cardiac myxomas can be excised with a low rate of mortality and morbidity.
Surgical experience with intracardiac myxomas
International Journal of Cardiology, 1988
Cardiac myxoma is generally considered to be a surgical emergency. Surgical excision must be done as soon as possible after diagnosis because of the high risk of valve obstruction or systemic embolization. In this study we report the result of operation in patient with benign cardiac myxoma. From 2001 to 2006, 35 patients (15 men and 20 women) between the ages of 26 and 82 years (mean of 52 ± 14 years) were operated on for cardiac myxoma. In all of them cardiac myxoma was excised with large cuff of atrial septum. The postoperative mortality was 2.9% (1 patient). No patient was lost in 5 years follow up. Emergency operation was performed in 80% of the patients; in the remaining (20%) of the patients, condition was stable and the clinical presentation was less worrying, so elective operation was done. Now as echocardiography can reveal smaller tumors in generally elderly patients, most cases of cardiac myxoma correspond to stable forms. With early diagnosis and surgical excision of atrial myxoma, 97.1% of patients survived post operatively and had an excellent short-term and long-term results leading to eventual cure of nonfamilial myxomas. However, familial myxomas retain a strong tendency to recur after excision.
Journal of thoracic disease, 2014
Cardiac myxoma is a benign neoplasm that represents the most prevalent primary tumor of the heart. If not treated with the right surgical technique recurrence occurs. Aim of our study is to present our surgical approach and the histology of the tumors resected. All patients, except for one, underwent extracorporeal circulation and mild hypothermia, right atrial or both atrial incision and excision of the fossa ovalis, followed by prosthetic patch suturing. All specimens were submitted for microscopic evaluation (haematoxylin-eosin). We contacted personally each patient and asked them to complete a standardized questionnaire, concerning their peri-operative characteristics. Six cases were "active" myxomas, 3 were "mildly active" and 3 were "inactive". "Normal differentiation" was seen in 6, "medium" in 1 and "poor" in 5 cases. In our series there were no recurrences recorded during the follow-up period. The ideal approach, a...
2002
Introduction . Primary neoplasms of the heart are very rare, benign cardiac myxomas being the most common. The aim of this study was to present the clinical profile and long-term outcome of patients (pts) who underwent surgical resection of cardiac myxoma. Material and methods . Between 1981 and 2000, 21 pts (12 female and 9 male), mean age 43.9 ± 14.5 years (range:21-74 yrs) underwent surgery for cardiac myxoma. Before surgery we performed physical examination, ECG, chest Xray, echocardiography (M + 2D) and coronary artery angiography (in patients over 40 years of age). All pts were operated by median sternotomy in moderate hypothermia (26-28°C) with the use of cardiopulmonary bypass. At the end of the follow up clinical examination and echocardiography (M + 2D) were performed. Results . Before operation 19 pts (90.5%) presented with cardiac signs related to mitral orifice obstruction. Six of them (28.6%) were NYHA class II, 8 (38.1%) - class III and 5 (23.8%) - class IV. Events of...
Cardiac myxomas: A single-center case series of 145 patients over a 32-year period study
Annals of Cardiac Anaesthesia, 2023
Background: Myxomas are the most common primary cardiac tumors that develop mostly at the atrial chambers of the heart and represent 0,25% of all cardiac diseases. Methods: This is a retrospective study aiming to analyze epidemiological and intraoperative data from cardiac myxoma cases in the hospital of the last 32 years. The study population was 145 cardiac surgical patients and was divided into 4 certain 8-year periods. 87,6% of cases had the myxoma located at left atrium and 97,2% of all patients fully recovered. 4,1% of patients relapsed and underwent a redo operation. Results: Mean CPB time and mean ICU length of stay increased during the 8-year periods (p < 0,001, P < 0,001, P = 0,002 and P = 0,003 respectively). In-hospital length of stay decreased to 5 days in the most recent period (p < 0,001). Cases significantly increased to 54 in the last 8-year period (p = 0,009). Conclusion: Improvement on cardiac imaging and a better accessibility may drive patients to earlier and safer diagnosis of myxomas preventing any deterioration of their condition. Improvement on postoperative care can also reduce in-hospital length of stay. Surgical excision is the treatment of choice and guaranteed survival at 97,2% of patients. Keywords: Cardiac imaging techniques; cardiopulmonary by-pass; in-hospital length of stay; left atrium myxoma.
Surgical excision of intracardiac myxomas: A 20-year follow-up
The Annals of Thoracic Surgery, 1990
Since November 1968, 54 patients have undergone excision of an intracardiac myxoma, which was located in the left atrium in 46 (85%), in the right atrium in 6 (ll%), and in the right ventricle in 2 (4%). There were 35 female and 19 male patients with a mean age of 48 f 14 years (range, 7 to 68 years). Four patients were asymptomatic; the others were seen mostly with exertional dyspnea, palpitation, signs of systemic illness, and syncopal episodes. Before operation, embolic episodes occurred in 13 patients with a left atrial myxoma. There were two early (3.7%) and two late deaths (3.8%). Actuarial survival at 20 years is 91% +-4%, and most of the current survivors are yxomas are the most frequent benign tumors in-M volving the cardiovascular system [l, 21. Since 1954, when Crafoord [3] reported the first successful excision of a left atrial (LA) myxoma, myxomas have been diagnosed and removed with increasing frequency because of the widespread use of echocardiography. Nevertheless, although management of cardiac myxomas has been the subject of many recent reports [&13], the longterm fate of the patients has been less frequently evaluated in large series. The purpose of this report is to present the early and late results, discuss some technical details, and assess by noninvasive techniques the current status of survivors by reviewing our 20-year experience with surgical intervention for intracardiac myxomas.