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Successful surgical resection of infected left atrial myxoma in a case complicated with disseminated intravascular coagulation and multiple cerebral infarctions: case report.

Yoshioka D, Takahashi T, Ishizaka T, Higuchi T - J Cardiothorac Surg (2011)

Bottom Line: Cardiac myxoma is the most common primary cardiac tumour, but infected cardiac myxoma is relatively rare.Until date, only one successful surgical treatment for a case complicated by DIC and cerebral infarctions has been reported, and our report describes second such case of successful resection.Even though this report is limited to a case, only aggressive and prompt surgical intervention could relieve the intractable conditions in such a patient with extremely high risk.

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Affiliation: Department of Cardiovascular surgery, Osaka National Hospital, 2-14 Hoenzaka, Chuo-ku, Osaka city, Osaka, 540-0006, Japan.

ABSTRACT
Cardiac myxoma is the most common primary cardiac tumour, but infected cardiac myxoma is relatively rare. Infected cardiac myxoma is very fragile, and has a potential to lead to catastrophic disorder with systemic bacteremia, systemic mycotic embolism, and disseminated intravascular coagulation (DIC).We present here the successful surgical treatment of a case of infected left atrial myxoma with septic shock, DIC and cerebral infarction without hemorrahage. Collective review of 58 reported cases with infected cardiac myxoma revealed that surgical treatment for it were still challenging and its result was poor. Until date, only one successful surgical treatment for a case complicated by DIC and cerebral infarctions has been reported, and our report describes second such case of successful resection. Even though this report is limited to a case, only aggressive and prompt surgical intervention could relieve the intractable conditions in such a patient with extremely high risk.

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Post-operative MRI showed a large cerebral haemorrhagic infarction in the right occipital lobe.
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Figure 3: Post-operative MRI showed a large cerebral haemorrhagic infarction in the right occipital lobe.

Mentions: Because of the low platelet count after the operation and to prevent hemorrhagic complications, no anticoagulation therapy was performed in during the post-operative course. But he suffered a brain haemorrhage in the occipital lobe, but fortunately, recovered wit slight cognitive decline (Figure 3). The patient was discharged two months after the operation with a normal C-reactive protein level and no fever was noted. Two years later, he is asymptomatic with no clinical evidence of recurrence.


Successful surgical resection of infected left atrial myxoma in a case complicated with disseminated intravascular coagulation and multiple cerebral infarctions: case report.

Yoshioka D, Takahashi T, Ishizaka T, Higuchi T - J Cardiothorac Surg (2011)

Post-operative MRI showed a large cerebral haemorrhagic infarction in the right occipital lobe.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3108288&req=5

Figure 3: Post-operative MRI showed a large cerebral haemorrhagic infarction in the right occipital lobe.
Mentions: Because of the low platelet count after the operation and to prevent hemorrhagic complications, no anticoagulation therapy was performed in during the post-operative course. But he suffered a brain haemorrhage in the occipital lobe, but fortunately, recovered wit slight cognitive decline (Figure 3). The patient was discharged two months after the operation with a normal C-reactive protein level and no fever was noted. Two years later, he is asymptomatic with no clinical evidence of recurrence.

Bottom Line: Cardiac myxoma is the most common primary cardiac tumour, but infected cardiac myxoma is relatively rare.Until date, only one successful surgical treatment for a case complicated by DIC and cerebral infarctions has been reported, and our report describes second such case of successful resection.Even though this report is limited to a case, only aggressive and prompt surgical intervention could relieve the intractable conditions in such a patient with extremely high risk.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiovascular surgery, Osaka National Hospital, 2-14 Hoenzaka, Chuo-ku, Osaka city, Osaka, 540-0006, Japan.

ABSTRACT
Cardiac myxoma is the most common primary cardiac tumour, but infected cardiac myxoma is relatively rare. Infected cardiac myxoma is very fragile, and has a potential to lead to catastrophic disorder with systemic bacteremia, systemic mycotic embolism, and disseminated intravascular coagulation (DIC).We present here the successful surgical treatment of a case of infected left atrial myxoma with septic shock, DIC and cerebral infarction without hemorrahage. Collective review of 58 reported cases with infected cardiac myxoma revealed that surgical treatment for it were still challenging and its result was poor. Until date, only one successful surgical treatment for a case complicated by DIC and cerebral infarctions has been reported, and our report describes second such case of successful resection. Even though this report is limited to a case, only aggressive and prompt surgical intervention could relieve the intractable conditions in such a patient with extremely high risk.

Show MeSH
Related in: MedlinePlus