Mixoma do átrio esquerdo: relato de 3 casos

Abstract

Entre outubro de 1987 e julho de 1994, foram operados, em nosso Serviço, (Clínica Cárdio-Cirúrgica de Juiz de Fora) 3 pacientes portadores de mixoma do átrio esquerdo. A idade variou de 20 a 35 anos, com média de idades de 29,6 anos, e o sexo feminino representou 66,6% dos casos. A ocorrência de palpitações taquicárdicas foi relatada por todos os pacientes (100%), seguindo-se dispnéia de esforço, desconforto precordial e episódios de tontura em 2 casos (66,6%). Manifestações inespecíficas como mal-estar, adinamia, anorexia e emagrecimento foram relatados por 1 paciente (33,3%). Nenhum paciente apresentou acidente embólico prévio. O diagnóstico da tumoração cardíaca foi realizado com auxílio da ecocardiografia bidimensional e do estudo hemodinâmico e a confirmação de mixoma foi dada pelo estudo histopatológico. Nas operações utilizou-se circulação extracorpórea e a atriotomia esquerda como via de acesso. Não houve complicações durante o ato cirúrgico e no pós-operatório os pacientes evoluíram de forma satisfatória; todos receberam alta hospitalar assintomáticos.<br>Between October 1987 and July 1994 three patients presenting left atrial myxoma underwent surgery in our Service _ Clínica Cárdio Cirúrgica de Juiz de Fora. Ages ranged from 20 to 35 years (average 29.6 years) and 66.6% of these cases were female patients. The occurrence of tachycardic palpitations was reported by all the patients (100%) following effort with dypnea, precordial discomfort and episodes of dizziness in two cases (66.6%). Non specific manifestations such as general uneasiness, prostration, anorexia and emaciation were reported by one patient (33.3%). None of the patients in this series presented previous embolic accident.The diagnosis of cardiac tumor was accomplished with the help of the two-dimensional echocardiography and the hemodynamic study. The confirmation of the myxoma was given by the histopathological study. Extracorporeal circulation was used in the surgeries and left atriotomy was used as an approach to the tumor. There were no complications during the surgery and post-operatively the patients evolved satisfactorily. All the patients were asymptomatic when discharged from the hospital

Ressecção de mixoma ventricular esquerdo após acidente vascular cerebral embólico

“…In spite of the benign histological character of these tumors, they can lead to unfavorable consequences for the patient, being responsible for disabling complications and even sudden death. Such tumors also may cause pulmonary and systemic embolic events due to their fragmentation or valve obstruction [2].…”

“…When this tumor is found in the left ventricle, it can evolve asymptomatically, causing peripheral arterial embolism or stroke. Embolic accidents have been reported frequently, which can cause disability or sudden death [2].…”

“…The echocardiogram, CT scan and resonance allow us to diagnose primary cardiac tumors without the use of invasive procedures [2].…”

“…The resection of the basis of the tumor implantation should be performed with good safety margin in order to avoid recurrence [2].…”

Qual o seu diagnóstico?

“…Cytogenetic analysis demonstrates clonal chromosomal abnormalities on which this concept is based (3) .…”