Concomitant percutaneous aortic embolectomy and excision of left atrial myxoma in a child

Abstract

Cardiac myxoma is rare in children and often associated with cerebrovascular events. Reported herein is the case of a 9-year-old boy who presented with acute obstruction of the aortic bifurcation associated with a huge left atrial (LA) myxoma, thereby leading to acute ischemia of the lower extremities. Immediate surgical removal of the LA myxoma with concomitant percutaneous embolectomy using a Forgathy catheter was done, with relief of ischemic symptoms. Cardiac myxoma should always be considered in the case of acute embolic events in children, given that it needs immediate intervention to prevent further complications.

Cryptogenic acute lower extremities and multiorgan ischemia in an 8-year-old girl

“… 2 , 5 , 6 , 11 In pediatric patients, ALI due to embolism has been previously attributed to cardiac sources, such as atrial myxoma. 12 In the absence of any obvious trauma or cardiac risk factors, it can be more difficult to diagnose ALI in this population. Transesophageal echocardiography in our patient did not show evidence of intracardiac thrombus or endocarditis; hence, the nidus for embolism in our patient remains unknown and cryptogenic.…”

Author's Reply to Systemic Inflammation in the Setting of Cardiac Myxomas: an Overview of Clinical and Practical Considerations

“…Treatment of cardiac myxoma is an urgent and complete surgical resection in order to prevent further complications and tumor recurrence. 5) 6) However, surgery for myxoma involving heart valve is complicated because valve repair or replacement are sometimes necessary to remove tumor tissue completely. Yuan et al 5) reported that about a half of patients needed additional procedures to preserve mitral valve function, with 21.6% of valve replacement.…”