Саратовский научно-медицинский журнал (Jun 2013)
Case report on extensive left atrial myxoma removal with permanent pacemaker implantation
Abstract
Aim: To represent a case report of extensive left atrial myxoma removal with permanent pacemaker implantation. Methods: A 56-year old female patient admitted to the Bakulev Center of Cardiovascular Surgery with cardiac evaluation. She noted progressive chest pain associated with dyspnea and fatigue. After physical examination, transthoracic echocardiography and other methods of evolution confirmed the diagnosis: Tumor of the left atrium. Left atrial dilatation. Left ventricle hypertrophy. Arterial hypertension 2 stage of high risk. Circulatory failure 2 stage (by Strazhesko-Vasilenko), functional class II by NYHA. The huge tumor was successfully excised with closure of atrial septal defect by patch. Results: Transthoracic echocardiography in postoperative period showed a normal left and right ventricular function and no residual shunts. The presence of conduction abnormalities in early postoperative period predicted the need for permanent pacemaker implantation. Conclusions: It must be noted rare occurrence of a huge tumor (myxoma) filling left atrium. Large left atrial tumor is approached by biatrial incision with further excision. It is believed that the case can be beneficial in huge cardiac tumors management. Early detection and surgical treatment of heart tumors can reduce the risk of heart failure, systemic embolization, syncope and sudden cardiac death.