Case of Dilated Cardiomyopathy in Combination with Left Atrial Myxoma and Left Atriomegaly (Rare Clinical Case)
Abstract
Case description. A 41-year-old male patient F. was admitted to the Department ofSurgical Treatment of Ac-quired Heart Diseases of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a diagnosis: Dilated cardiomyopathy. Mitral-tricuspid insufϐiciency. Left atrial myxoma. Left atriomegaly. Pulmonary hypertension. The patient was operated with heart failure symptoms of NYHA functional class IV.
After a week of medical preparation and additional examination,the patient was successfully operated on (remov-al of the left atrial myxoma, imposition of support rings on the left and right atrioventricular openings, paraanular plicacy of the left atrium). The postoperative period proceededwithout signiϐicant complications. On the 12th day after the operation, the patient was discharged in satisfactorycondition. In the remote period the patient died suddenly 3 years later.
Conclusion. Taking into account the initial serious condition of a patient with advanced heart disease with a reduced left ventricular ejection fraction, left atriomegaly (7.8 cm), pulmonary hypertension (50 mm Hg) and comorbidities, complex reconstruction of the left heart in atriomegaly and ventriculomegaly leads to an improvement in the functional state of the myocardium and morphometric indicators of left atrium and left ventricular ejection fraction.
References
- Hu J, Lee APW, Wei X, Cheng ZY, Ho AMH, Wan S. Update on surgical repair in functional mitral regurgitation. J Card Surg. 2022;37(10):3328-35. https://doi.org/10.1111/jocs.15771
- Chen L, Chen B, Hao J, Wang X, Ma R, Cheng W, et al. Complete Preservation of the Mitral Valve Apparatus during Mitral Valve Replacement for Rheumatic Mitral Regurgitation in Patients with an Enlarged Left Ventricular Chamber. Heart Surg Forum. 2013;16(3):E137-43. https://doi.org/10.1532/HSF98.20121128
- Prabhu S, McLellan AJ, Walters TE, Sharma M, Voskoboinik A, Kistler PM. Atrial structure and function and its implications for current and emerging treatments for atrial fibrillation. Prog Cardiovasc Dis. 2015;58(2):152-67. https://doi.org/10.1016/j.pcad.2015.08.004
- Limongelli G, Adorisio R, Baggio C, Bauce B, Biagini E, Castelletti S, et al.; WG on Cardiomyopathies of SIC (Società Italiana di Cardiologia); WG on Cardiomyopathies of SICPed (Società Italiana di Cardiologia Pediatrica). Diagnosis and Management of Rare Cardiomyopathies in Adult and Paediatric Patients. A Position Paper of the Italian Society of Cardiology (SIC) and Italian Society of Paediatric Cardiology (SICP). Int J Cardiol. 2022;357:55-71. https://doi.org/10.1016/j.ijcard.2022.03.050
- Popov VV, Bolshak AA, Boukarim VZ. [Triangular plasty of left atrium in correction of mitral failure]. Klinicheskaia Khirurgiia. 2021;88(3-4):3-7. Ukrainian. https://doi.org/10.26779/2522-1396.2021.3-4.03
- Ostovar R, Schmidt M, Schroeter F, Kuehnel RU, Rashvand J, Hartrumpf M, et al. Do Not Withhold Mitral Surgery from Patients with Poor Left Ventricular Function. Medicina (Kaunas). 2022;58(9):1220. https://doi.org/10.3390/medicina58091220
- Abd Elaziz ME, Ibrahim IM. Reversal of Left Ventricular Functions in Chronic Mitral Regurgitation after Mitral Valve Replacement. Heart Surg Forum. 2016;19(4):E160-4. https://doi.org/10.1532/hsf.1440
- Kurfirst V, Mokráček A, Krupauerová M, Canádyová J, Bulava A, Pešl L, et al. Health-related quality of life after cardiac surgery--the effects of age, preoperative conditions and postoperative complications. J Cardiothorac Surg. 2014;9:46. https://doi.org/10.1186/1749-8090-9-46
- Guo Y, He S, Wang T, Chen Z, Shu Y. Comparison of modified total leaflet preservation, posterior leaflet preservation, and no leaflet preservation techniques in mitral valve replacement - a retrospective study. J Cardiothorac Surg. 2019;14(1):102. https://doi.org/10.1186/s13019-019-0918-7
- Restivo L, De Luca A, Fabris E, Pagura L, Pierri A, KorcovaR, et al. A 20-year experience in cardiac tumors: a single center surgical experience and a review of literature. J Cardiovasc Med (Hagerstown). 2022;23(11):722-7. https://doi.org/10.2459/JCM.0000000000001375
- Meng XH, Xie LS, Xie XP, Liu YC, Huang CP, Wang LJ, et al. Cardiac myxoma shedding leads to lower extremity arterial embolism: A case report. World J Clin Cases. 2022;10(29):10606-13. https://doi.org/10.12998/wjcc.v10.i29.10606
- Snoussi NEH, Serroukh Y, El Hattab FZ, Cherti M. Giant LeftAtrial Myxoma Revealed by Syncopal Attacks. J Saudi Heart Assoc. 2022;34(2):113. https://doi.org/10.37616/2212-5043.1305
- Baba A, Hisata Y, Odate T, Yamada T. A giant left atrial myxoma causing left-sided heart failure. SAGE Open Med Case Rep. 2022;10:2050313X221105829. https://doi.org/10.1177/2050313X221105829
- Griborio-Guzman AG, Aseyev OI, Shah H, Sadreddini M. Cardiac myxomas: clinical presentation, diagnosis and management. Heart. 2022;108(11):827-33. https://doi.org/10.1136/heartjnl-2021-319479