RESUMO
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.
Assuntos
Fístula , Neoplasias Cardíacas , Mixoma , Idoso , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Feminino , Fístula/diagnóstico por imagem , Fístula/cirurgia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Mixoma/complicações , Mixoma/diagnóstico por imagem , Mixoma/cirurgiaRESUMO
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.
Assuntos
Tamponamento Cardíaco , Aneurisma Coronário , Idoso de 80 Anos ou mais , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/cirurgia , Aneurisma Coronário/complicações , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/cirurgia , Angiografia Coronária , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Feminino , Humanos , JapãoRESUMO
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.
