Case report: Using the so-called "sutureless-technique" for the treatment of a giant right atrium myocardial lipoma.
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SUBMITTER: Marinos SL
PROVIDER: S-EPMC9735422 | biostudies-literature | 2022 Dec
REPOSITORIES: biostudies-literature
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Case report: Using the so-called "sutureless-technique" for the treatment of a giant right atrium myocardial lipoma.
Marinos Spiros Lukas SL Boburg Rodrigo Sandoval RS Mustafi Migdat M Schlensak Christian C
JTCVS techniques 20221004
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Project description:RationaleCardiac lipomas are known to cause functional disturbances and symptoms by compressing adjacent tissues or organs, leading to potential complications such as dyspnea, palpitations, and cardiac arrhythmias. We report a case of a 52-year-old female with a large, well-circumscribed lipoma in the right atrium. This rare condition required a comprehensive diagnostic approach and therapeutic strategy for effective management.Patient concernsA 52-year-old female patient presented to the hospital with complaints of palpitations and fatigue lasting for 1 month, accompanied by the recent discovery of a cardiac mass via echocardiography over the past 2 days. In addition, she reported occasional episodes of a dry cough.DiagnosesBoth echocardiography and cardiac computed tomography imaging revealed an isoechoic mass within the right atrium, characterized by a regular shape and close attachment to the right atrial wall, displaying noticeable mobility. Histopathological analysis following surgical intervention confirmed that the tumor was predominantly comprised of adipocytes.InterventionsThe patient underwent successful resection of the right atrial lipoma, followed by reconstruction of right atrium using a bovine pericardial patch under extracorporeal circulation with a beating heart.OutcomesPostoperative recovery was complete, with resolution of symptoms including palpitations and fatigue. A follow-up echocardiogram on the 66th day postsurgery confirmed the absence of any residual tumor.LessonsPatients with small lipoma often remain asymptomatic. However, large or rapidly progressing tumors may elicit symptoms such as chest pain, dyspnea, and palpitations. For asymptomatic patients with small tumors, regular observation and follow-up are typically advised to monitor tumor growth and the emergence of symptoms. Conversely, patients with large tumors or overt symptoms should be recommended for prompt surgical intervention. In this case, preoperative anatomical evaluation for the lipoma involves the right atrial free wall, which is crucial to prevent excessive resection, damage to the lateral bundle branch, and subsequent postoperative cardiac dysfunction or arrhythmia, as exemplified in this patient.
| S-EPMC11789880 | biostudies-literature
Project description:Dilated cardiomyopathy (DCM) is one of the leading causes of heart failure in children with diverse clinical characteristics. To date, DCM with a giant atrium as the first manifestation is rare and has not been reported in previous literature. We report a case of a male infant born with a significantly enlarged right atrium. Due to worsened clinical symptoms and the risk of arrhythmias and thrombosis, we performed the surgical reduction of the right atrium. Unfortunately, DCM and a progressive re-enlargement of the right atrium appeared during midterm follow-up. The mother's echocardiogram also suggested DCM, and the patient was eventually considered for a diagnosis of familial DCM. This case may expand the clinical spectrum of DCM and reminds us of the importance of good follow-up of children with idiopathic dilatation of the right atrium.
| S-EPMC10050595 | biostudies-literature
Project description:A lipoma is a benign tumor which can occur in any part of the body; it is very frequent and can reach a considerable size. Differentiation between lipoma and liposarcoma of low grade malignancy represents an important diagnostic problem, and valuable help in the differential diagnosis is provided by ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), biopsy and/or modern immunohistochemistry. The authors report the case of a 50-year-old man who was referred to their department due to the presence of a large mass growing on the upper thigh of the right leg; over 7 years it had steadily increased in size causing pain and functional impotence. US of the soft tissues and CT scanning were performed. Densitometric values of the mass suggested adipose tissue, which was subsequently confirmed by biopsy.
| S-EPMC3558071 | biostudies-literature
Project description:BackgroundDue to structural valve deterioration of sutureless aortic prosthesis, there is a need for explantation of the prothesis. We introduce a surgical technique to explant sutureless aortic prosthesis, which has a self-expanding stent incorporated into the aortic wall.Case presentationAn 82-year-old man who had undergone sutureless aortic valve replacement 6 years previously underwent redo-aortic and mitral valve replacement because of severe prosthetic aortic valve stenosis and mitral regurgitation. The sutureless prosthesis was explanted using 'lasso technique'. The patient was discharged after 7 days without complications.ConclusionsWe presented a useful technique to explant a sutureless aortic prosthesis.
| S-EPMC9903434 | biostudies-literature
Project description: Not available
| S-EPMC8114721 | biostudies-literature
Project description:IntroductionTeratomas are neoplasms originating from embryonic tissues, characterized by a diverse composition of cells from all three germ layers in varying ratios. Rarely reported in the heart, we present here a rare case of a teratoma in the right atrium of a newborn.Case presentationA 20-h-old newborn was referred for a mild heart murmur. An echocardiogram revealed a 6 × 9 mm mass in the right atrium, attached to the interatrial septum. The mass caused mild tricuspid regurgitation without any significant pressure gradient. Surgery to remove the mass was successful. Pathological examination confirmed the mass as a teratoma. The child was discharged in excellent health and has had normal follow-up exams.DiscussionMature teratomas, a common type of germ cell tumor, are rare in the mediastinum, accounting for 10-15 % of mediastinal masses. These tumors arise from displaced primordial germ cells, which may become malignant. They can metastasize to the heart via various routes, causing symptoms like cough, dyspnea, and chest pain due to compression of mediastinal structures. Severe cases may lead to superior vena cava syndrome or hemoptysis. Tumor location influences clinical presentation, with some posing life-threatening risks.ConclusionEarly diagnosis and intervention were crucial in preventing severe complications. This case emphasizes the importance of vigilant clinical evaluation and timely surgical management for infants presenting with cardiac symptoms.
| S-EPMC11562404 | biostudies-literature
Project description:Spontaneous pneumothorax is one of the most common conditions encountered in thoracic surgery. This condition can be treated conservatively or surgically based on indications and guidelines. Traditional surgical management includes pleurodesis (mechanical or chemical) in addition to bullectomy if the bullae can be identified. Mechanical pleurodesis is usually performed by surgical pleurectomy or pleural abrasion. In this case report, we present a case of a young patient with spontaneous pneumothorax who needed a surgical intervention. We performed a new, innovative surgical technique for surgical pleurectomy where we used carbon dioxide for dissection of the parietal pleura (capnodissection). This technique may provide similar efficiency to the traditional procedure but with less risk of bleeding and complications.
| S-EPMC11226924 | biostudies-literature
Project description:BackgroundPelvic lipomas, particularly when massive in size, present unique surgical challenges due to their intricate anatomical location and proximity to vital structures. Complete resection of tumor is the basic principle. In this case, we demonstrated the complete resection of a huge pelvic lipoma by laparoscopy combined with a transsacral approach, which was rarely reported in the relevant literature. According to our case, a two-step abdomino-parasacral approach provides more flexibility, but also a safe and easier dissection in deep pelvic.Case descriptionA 74-year-old female presented to the outpatient clinic, complaining of abdominal distension and difficulty in defecation for over 6 months. The patient had no obvious concomitant symptoms and she had a history of hypertension. After completing the relevant tests, the patient was diagnosed with a pelvic tumor, possibly a lipoma. We performed a two-step abdomino-parasacral approach to remove the tumor and the tumor was confirmed as lipoma. There was no tumor recurrence sign after 7 months follow-up for the patient.ConclusionsA two-step abdomino-parasacral resection of the lipomatous tumor were advantageous to manage en bloc resection of a giant pelvic lipoma in our case report. This case report can provide some reference for the treatment of pelvic giant lipoma in the future.
| S-EPMC11399849 | biostudies-literature
Project description:We herein present a case of infective endocarditis of the mitral valve and a paravalvular abscess around the tricuspid valve. Preoperative blood culture confirmed the presence of pathogenic diphtheroids. During the operation, an unexpected infection of the free wall of the right atrium (RA) near the tricuspid annulus was found. We harvested the left atrial appendage (LAA) en bloc. After resection of the infected and abnormal tissues, the resected LAA was used to reconstruct the RA. The infected mitral valve was replaced with a mechanical valve without any accident. Postoperative echocardiography showed that the RA had a supple shape, with no kinking.
| S-EPMC8645954 | biostudies-literature
Project description:A 31-year-old woman was referred to our hospital for evaluation of a cardiac mass in the right atrium. Cardiac magnetic resonance imaging indicated a cystic mass filled with fluid accumulation in the right atrium. The mass was identified as a cardiac cyst and was surgically removed. Pathological examination revealed an extremely rare bronchogenic cyst. Bronchogenic cysts are benign congenital abnormalities of primitive foregut origins that form in the mediastinum during embryonic development. There is unusual clinical dilemmas surrounding the treatment plan for cardiac surgery or biopsy of cardiac masses, especially in patients with rare cardiac cysts. The anatomical location of the cyst can be related to various clinical symptoms and complications. In cases of indeterminate cardiac cysts, direct cyst removal without prior biopsy is of utmost importance.
| S-EPMC9197382 | biostudies-literature