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Cryoablation for a right atrial myxoma arising from the Koch's triangle: a case report.

Marinakis S, Mircev D, Wauthy P - J Cardiothorac Surg (2013)

Bottom Line: A 78-year-old caucasian patient with compromised cardiac function presenting recurrent episodes of pulmonary embolism was referred to our center for resection of a voluminous right atrial myxoma arising from the Koch's triangle.To preserve the conduction system, we performed an excision of the myxoma associated with cryoablation of its stalk.This case is of special interest for discussing possibilities of preservation of the atrioventricular conduction system in such situations, provided that the contemporary literature does not propose concrete guidelines.

View Article: PubMed Central - HTML - PubMed

Affiliation: Departement of Cardiac Surgery, Brugmann Hospital, Brussels, Belgium, Place Van Gehuchten 4, 1020 Brussels, Belgium. s.marinakis@live.com.

ABSTRACT
A 78-year-old caucasian patient with compromised cardiac function presenting recurrent episodes of pulmonary embolism was referred to our center for resection of a voluminous right atrial myxoma arising from the Koch's triangle. To preserve the conduction system, we performed an excision of the myxoma associated with cryoablation of its stalk. This case is of special interest for discussing possibilities of preservation of the atrioventricular conduction system in such situations, provided that the contemporary literature does not propose concrete guidelines.

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Pathologoanatomic specimen of the myxoma.
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Figure 4: Pathologoanatomic specimen of the myxoma.

Mentions: Given the fact that complete ablation with creation of an atrial septal defect in this area would result in a total atrioventricular block in a patient with major alteration of the LVEF, we decided to perform an excision of the myxoma at its base and a cryoablation (-110°C) of the insertion of its stalk for 60 seconds (Figure 3). The intraoperative TEE revealed no residual tumor, and the histopathologic examination of the specimen confirmed the diagnosis of a benign myxoma (Figure 4). The postoperative period was uneventful, and the patient presented no conduction problems in the perioperative and postoperative periods.


Cryoablation for a right atrial myxoma arising from the Koch's triangle: a case report.

Marinakis S, Mircev D, Wauthy P - J Cardiothorac Surg (2013)

Pathologoanatomic specimen of the myxoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4222061&req=5

Figure 4: Pathologoanatomic specimen of the myxoma.
Mentions: Given the fact that complete ablation with creation of an atrial septal defect in this area would result in a total atrioventricular block in a patient with major alteration of the LVEF, we decided to perform an excision of the myxoma at its base and a cryoablation (-110°C) of the insertion of its stalk for 60 seconds (Figure 3). The intraoperative TEE revealed no residual tumor, and the histopathologic examination of the specimen confirmed the diagnosis of a benign myxoma (Figure 4). The postoperative period was uneventful, and the patient presented no conduction problems in the perioperative and postoperative periods.

Bottom Line: A 78-year-old caucasian patient with compromised cardiac function presenting recurrent episodes of pulmonary embolism was referred to our center for resection of a voluminous right atrial myxoma arising from the Koch's triangle.To preserve the conduction system, we performed an excision of the myxoma associated with cryoablation of its stalk.This case is of special interest for discussing possibilities of preservation of the atrioventricular conduction system in such situations, provided that the contemporary literature does not propose concrete guidelines.

View Article: PubMed Central - HTML - PubMed

Affiliation: Departement of Cardiac Surgery, Brugmann Hospital, Brussels, Belgium, Place Van Gehuchten 4, 1020 Brussels, Belgium. s.marinakis@live.com.

ABSTRACT
A 78-year-old caucasian patient with compromised cardiac function presenting recurrent episodes of pulmonary embolism was referred to our center for resection of a voluminous right atrial myxoma arising from the Koch's triangle. To preserve the conduction system, we performed an excision of the myxoma associated with cryoablation of its stalk. This case is of special interest for discussing possibilities of preservation of the atrioventricular conduction system in such situations, provided that the contemporary literature does not propose concrete guidelines.

Show MeSH
Related in: MedlinePlus