An Unusual Biatrial Cardiac Myxoma in a Young Patient

This is a report of a biatrial cardiac myxoma in a young man with a 10-month history of exertional dyspnea and palpitation. The echocardiogram revealed biatrial myxoma prolapsing through the mitral and tricuspid valves during diastole. All cardiac chambers were enlarged and dysfunctional. The electrocardiogram revealed a rapid ventricular response with atrial flutter rhythm. The masses were resected and diagnosed as myxoma by a histological examination. The follow-up echocardiogram revealed significant improvement in ventricular function and reduction in the cardiac chambers' volume. There was no evidence of myxoma recurrence. The most probable cause of the patient's heart failure was considered to be tachycardia-induced cardiomyopathy.

Carcinoid heart disease and the utility of 3D trans-thoracic and trans-esophageal echocardiography: two clinical cases

Carcinoid tumors are rare neuroendocrine malignancies. We present two cases of metastatic carcinoid tumors, complicated by carcinoid syndrome and by cardiac valve involvement. Carcinoid syndrome is characterized by secretory diarrhea, episodic flushing, and bronchospasm. Cardiac involvement occurs in up to 50% of patients with metastatic carcinoid tumors which commonly causes abnormalities of the right sided valves. Echocardiography is the best available and non invasive technique for diagnosis. Characteristic features of carcinoid heart disease are thickened, shortened, retracted, and fixed or partially fixed valve leaflets. Three-dimensional [3D] echocardiography provided an en face view of pulmonary and tricuspid valve, not obtainable by two-dimensional echocardiography, and improved delineation of the relationship between these structures and cardiac chambers

An Improved Technique for Pulmonary Endarterectomy

We report a modified technique for pulmonary endarterectomy (PEA) on a 67-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) who presented with dyspnea. He was referred to our medical center for coronary artery bypass grafting. CTEPH had not been detected in his first visit to another medical center, but upon re-evaluation, the diagnosis was confirmed. PEA was performed with a modified method, which seems to be safe and suitable for the removal of clot and fibrotic materials. Iatrogenic dissection was performed with normal saline injection in the pulmonary artery, and then, the clot was removed completely. Although the technique may not be applicable for all cases, it can be used as an alternative to using an aspirating dissector and a pair of forceps.