Successful surgical resection of infected left atrial myxoma in a case complicated with disseminated intravascular coagulation and multiple cerebral infarctions: case report

Yoshioka, Daisuke; Takahashi, Tetsuya; Ishizaka, Toru; Higuchi, Takayoshi

doi:10.1186/1749-8090-6-68

Cited by 17 publications

(12 citation statements)

References 6 publications

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“…Nineteen (14.3%) patients had other than cerebral artery embolisms, with systemic multiple emboli in 4 (21.1%) [ 55 , 63 , 71 , 80 ] , peripheral multiple emboli in 3 (15.8%) [ 19 , 72 , 85 ] and solitary arterial embolus in 12 (63.2%) patients [ 9 , 11 , 13 , 16 , 21 , 35 , 41 , 43 , 60 , 76 , 84 ] . The 39 affected arteries in 18 patients were listed in Table 8 .…”

Section: Resultsmentioning

confidence: 99%

Stroke of a cardiac myxoma origin

Yuan¹,

Humuruola²

2015

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveThe clinical features of cardiac myxoma stroke have not been sufficiently described. Debates remain concerning the options and timing of treatment and the clinical outcomes are unknown. This article aims to highlight the pertinent aspects of this rare condition.MethodsData source of the present study came from a comprehensive literature collection of cardiac myxoma stroke in PubMed, Google search engine and Highwire Press for the year range 2000-2014.ResultsYoung adults, female predominance, single cerebral vessel (mostly the middle cerebral artery), multiple territory involvements and solitary left atrial myxoma constituted the outstanding characteristics of this patient setting. The most common affected cerebral vessel (the middle cerebral artery) and areas (the basal ganglion, cerebellum and parietal and temporal regions) corresponded well to the common manifestations of this patient setting, such as conscious alteration, ataxia, hemiparesis and hemiplegia, aphasia and dysarthria. Initial computed tomography scan carried a higher false negative rate for the diagnosis of cerebral infarction than magnetic resonance imaging did. A delayed surgical resection of cardiac myxoma was associated with an increased risk of potential consequences in particular otherwise arterial embolism. The mortality rate of this patient population was 15.3%.ConclusionCardiac myxoma stroke is rare. Often does it affect young females. For an improved diagnostic accuracy, magnetic resonance imaging of the brain and echocardiography are imperative for young stroke patients in identifying the cerebral infarct and determining the stroke of a cardiac origin. Immediate thrombolytic therapy may completely resolve the cerebral stroke and improve the neurologic function of the patients. An early surgical resection of cardiac myxoma is recommended in patients with not large territory cerebral infarct.

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Section: Resultsmentioning

confidence: 99%

Stroke of a cardiac myxoma origin

Yuan¹,

Humuruola²

2015

Revista Brasileira De Cirurgia Cardiovascular

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“…In such cases, the tumour mass can become friable, with associated bacteraemia, systemic embolism and/or disseminated intravascular coagulation. Polymorphonuclear infiltration of the tumour may be evident and Gram‐staining of the infected portion can reveal the presence of bacteria …”

Section: Gross Pathologymentioning

confidence: 99%

The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology

2014

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Cardiac myxoma is the most common benign cardiac tumour, localized generally in the left atrium. The majority of cardiac myxomas occur sporadically, while a relatively small proportion of cases develop as a part of Carney complex syndrome. Currently, the histogenesis of myxoma is poorly understood; however, the mesenchymal and endothelial properties of myxoma cells suggest that a clearer understanding of tumour origins can be achieved through a detailed investigation of heart development and endocardial histogenesis. Growing evidence appears to indicate the reactivated expression in cardiac myxoma of genes encoding heart precursor markers, although the exact mechanisms have not yet been described. In this paper we review the most recent scientific literature concerning cardiac embryology and relate this to recent advances in our understanding of the histogenesis of cardiac myxoma. Moreover, given that much of the literature regarding myxoma is of single case reports, we review progress in our knowledge of the pathology and pathogenesis of this condition.

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“…As pre-operative attempts failed to correct DIC, aneurysmal surgery was performed despite uncorrected coagulopathy. Yoshioka et al [6] reported a 52-year-old male who presented with DIC complicating infected left atrial myxoma. Septic embolization from the tumour necessitated an emergency open cardiac surgery to remove the tumour.…”

Section: Discussionmentioning

confidence: 98%

Uncorrectable coagulopathy due to intestinal obstruction: A clinical dilemma of competing priorities in a child

Raveenthiran¹,

Balachandran²

2013

Afr J Paediatr Surg

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Disseminated intravascular coagulation (DIC) is a contraindication for major surgical operations. However, if surgery is required to correct the underlying cause of DIC, a clinical conflict is created. In such complex scenario, standard resources such as textbooks and journals offer very little guidance. In this communication, we report a 22-month-old boy who developed sepsis-induced DIC following intestinal obstruction. Pre-operative attempts to normalize coagulation parameters failed. Damage control laparotomy was undertaken as it was considered essential to control the underlying cause of DIC. His abnormal coagulation status reverted quickly after surgical relief of intestinal obstruction. Paradoxically intraoperative blood loss was less than anticipated amount. There are a few case reports of adult patients who have successfully undergone major surgery despite the presence of abnormal coagulation. However, this appears to be the first paediatric report of successful surgery in DIC status. Lessons learnt from this case and hypothetical speculations of clinical paradoxes are discussed.

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Successful surgical resection of infected left atrial myxoma in a case complicated with disseminated intravascular coagulation and multiple cerebral infarctions: case report

Cited by 17 publications

References 6 publications

Stroke of a cardiac myxoma origin

Stroke of a cardiac myxoma origin

The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology

Uncorrectable coagulopathy due to intestinal obstruction: A clinical dilemma of competing priorities in a child

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