Lipoma de átrio direito / Lipoma of the right atrium

The patient is a 54-year-old asymptomatic male with a tumor in the right atrium that was diagnosed on transesophageal echocardiography and confirmed as a lipoma of the right atrium on computerized tomography. The patient underwent surgical repair with extracorporeal circulation. The tumor was resected, and its base of implantation in the atrium was repaired with a flap of bovine pericardium. The diagnosis of lipoma was confirmed on histopathological examination. Locating of the tumor with the aid of transesophageal echocardiography was very useful in the strategy of cannulation of the venae cava for installation of the circuit of extracorporeal circulation. The patient had a good postoperative evolution

Evoluçäo imediata de pacientes submetidos a aneurismectomia de ventrículo esquerdo / Short-term follow-up of patients after aneurysmectomy of the left ventricle

OBJECTIVE: Left ventricular aneurysm is a complication of myocardial infarction that can best be treated by reconstructive surgeries that can restore ventricular geometry. We analyzed immediate results in a group of consecutive patients who underwent surgical correction of left ventricular aneurysms. METHODS: From January '90 to August '99, 94 patients - mean age 58.4 (ranging from 36 to 73 years), 65 (69.1 percent) males and 9 ( 30.8 percent) females - were operated upon. Pre-operative ejection fraction ranged from 0.22 to 0.58 (mean = 0.52), and the aneurysm was located in the antero-lateral area in 90.4 percent of the cases. Functional class III and IV (NYHA) was present in 82 (87.2 percent) patients, and 12 (12.7 percent) were in functional class I and II. Congestive heart failure was the most frequent cause (77.6 percent), occurring in isolation in 24.4 percent or associated with coronary artery diseases in 53.2 percent. RESULTS: Short-term follow-up showed a 7.4 percent mortality, and low cardiac output was the main cause of death. Coming off pump was uneventful in 73 patients (77.6 percent), with a 3.2 percent mortality and with the use of inotropics in 20 (21.3 percent). One patient (1 percent) did not come off the pump. CONCLUSION: Surgical correction was adequate in the immediate follow-up of operated patients, and mortality was higher in patients with higher functional class