Minimally Invasive Resection Of Atrial Myxoma With Patent Foramen Ovale And Embolic Phenomenon
Clauden Louis, Peter Knight.
URMC, Rochester, NY, USA.
OBJECTIVE: The purpose of this study is to describe rare intraoperative findings in a patient with left atrial myxoma with embolic phenomenon of completely occluded right femoral artery found on attempted cannulation of a patient with new onset unexplained transient ischemic attacks (TIA).
METHODS: Complex clinical case report.
RESULTS: The minimally invasive surgical resection for atrial myxoma requires ectopic sites for arterial and venous cannulation. Successful cannulation of the left femoral artery after failed attempts in the right femoral artery was successfully performed. A polypoid lesion of 70 grams was extracted without complication from the left atrial cavity. Patient had resolution of his transient ischemic attacks and right leg numbness. A postoperative CT angiogram was significant for partial occlusion of the right femoral artery.
CONCLUSIONS: The minimally invasive procedures provide an opportunity to limit pain, infection and hospital stay following mini thoracotomy for surgical exposure of the heart. Cannulation of ectopic sites must be fully evaluated in order to successfully place such patients on bypass. In our case report we described a patient’s whose primary lesion provided secondary complications in regards to achieving successful cannulation of the right femoral artery. Due to concurrent TIA’s in the patient, Magnetic Resonance Imaging was opted in favor of CT imaging which revealed tumor embolus of the brain however did not provide the surgical team insight of the distal arterial obstruction. Intraoperative changes were required to successfully complete the resection.
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