RESUMO
Intravenous leiomyomatosis (IVL) is a benign tumor that originates from a uterine myoma and rarely extends to the heart through the inferior vena cava (IVC). Echocardiography revealed an abnormal mass in the right atrium in a 63-year-old asymptomatic woman. Preoperative examination revealed a tumor extending from a myoma through the right internal iliac vein to the right atrium, and the patient was diagnosed with IVL. She underwent sternotomy combined with laparotomy, and the intravenous and intracardiac tumor was removed under normothermic cardiopulmonary bypass without cardiac arrest. Hysterectomy and bilateral adnexectomy were also performed. No additional therapy was required after surgery.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Átrios do Coração/cirurgia , Neoplasias Cardíacas/cirurgia , Leiomiomatose/cirurgia , Neoplasias Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Veia Cava Inferior/cirurgia , Ponte Cardiopulmonar , Diagnóstico por Imagem , Feminino , Átrios do Coração/patologia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/patologia , Humanos , Laparotomia , Leiomiomatose/diagnóstico , Leiomiomatose/patologia , Pessoa de Meia-Idade , Invasividade Neoplásica , Articulação Esternoclavicular , Resultado do Tratamento , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/patologia , Veia Cava Inferior/patologiaRESUMO
We report a case of a patent venous graft for the left anterior descending branch 25 years after surgery. In 1986 at the age of 59 years, the patient underwent coronary artery bypass grafting( CABG) to the left anterior descending(LAD)artery using a saphenous vein graft (SVG). In 2011, twenty-five years after the surgery, the patient experienced a chest pain and was hospitalized. Due to a strong chest pain and pulmonary edema, emergency coronary angiography was performed under tracheal intubation. The SVG was patent, but severe stenosis was found proximal to the middle of the graft. Although percutaneous coronary intervention with a bare-metal stent was performed, the patient died of ventricular fibrillation on the 38th postoperative day. The use of arterial grafts for CABG is currently predominant, but SVG should still be considered a reliable alternative.
