ABSTRACT
A 76-year-old woman underwent screening echocardiography. A cardiac mass was detected in the left atrium. It was located at the atrial septum, and was around 3 cm in size. Its surface was smooth and there was cystic cavity inside. Coronary angiography revealed rich blood flow from bilateral coronary arteries to the mass and massive shunt to the left atrium, which formed a fistulous connection. We performed tumor resection under cardiopulmonary bypass. Postoperative course was uneventful. Histopathologically, the tumor was myxoma. Cardiac myxoma is the most common primary cardiac tumor, but myxoma exhibiting coronary artery-left atrial fistula is fairly uncommon.
Subject(s)
Fistula , Heart Neoplasms , Myxoma , Aged , Coronary Vessels/diagnostic imaging , Coronary Vessels/surgery , Female , Fistula/diagnostic imaging , Fistula/surgery , Heart Atria/diagnostic imaging , Heart Atria/surgery , Heart Neoplasms/complications , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/surgery , Humans , Myxoma/complications , Myxoma/diagnostic imaging , Myxoma/surgeryABSTRACT
We report a case of a ruptured coronary artery aneurysm. An 87-year-old woman suffered from cardiac tamponade due to a ruptured coronary artery aneurysm. Coronary angiography showed a giant coronary aneurysm without coronary artery fistula. Emergency surgery was performed through median sternotomy. We performed aneurysmectomy and ligation of the perfusion arteries under cardiopulmonary bypass. The patient's postoperative course was uneventful. We also reviewed nine cases of ruptured coronary artery aneurysm without coronary artery fistula in Japan. The disease is a rare clinical state and considered to be an indication for emergency surgery.
Subject(s)
Cardiac Tamponade , Coronary Aneurysm , Aged, 80 and over , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/etiology , Cardiac Tamponade/surgery , Coronary Aneurysm/complications , Coronary Aneurysm/diagnostic imaging , Coronary Aneurysm/surgery , Coronary Angiography , Coronary Vessels/diagnostic imaging , Coronary Vessels/surgery , Female , Humans , JapanABSTRACT
A 75-year-old woman was involved in a traffic accident and suffered retrograde type A aortic dissection, multiple rib fractures, and grade II hepatic injury accompanied by intraperitoneal bleeding. We performed total arch replacement using an open stent graft with cardiopulmonary bypass and circulatory arrest. This procedure requires anticoagulation and hypothermia, which are principally contraindicated in severe trauma patients. However, this situation was resolved by managing the patient non-operatively for 7 days, confirming the stabilization of other injured organs, and then performing the surgery. She required prolonged postoperative rehabilitation; however, she recovered steadily.
