Murayama J, Itoh T, Natsuaki M, Suenaga E, Suda H
Department of Cardiovascular Surgery, Saga Medical School, Saga, Japan.
Kyobu Geka. 2003 Dec;56(13):1130-3.
A 76-year-old man was admitted to our hospital because of surgical treatment for mass in the left atrium(LA). Echocardiography and computed tomography(CT) revealed mobile mass in LA which had stalk at the left atrial appendage. It was difficult to distinguish myxoma from thrombus. LA mass has risk of sudden circulatory collapse and systemic emboli, so it is indicated for emergent operation. Mass resection with appendage was performed through the transseptal superior incision using cardiopulmonary bypass. Pathological diagnosis was thrombus. Most of LA thrombus were complicated with mitral stenosis, LA thrombus without mitral disease is rare. A few authors reported the useful of CT and echocardiography, but we could not lead to precise diagnosis from preoperative image.
一名76岁男性因左心房(LA)肿物接受手术治疗而入住我院。超声心动图和计算机断层扫描(CT)显示左心房有活动肿物,其蒂位于左心耳。很难将黏液瘤与血栓区分开来。左心房肿物有导致突然循环衰竭和全身性栓塞的风险,因此建议进行急诊手术。通过经房间隔上切口在体外循环下进行肿物及心耳切除术。病理诊断为血栓。大多数左心房血栓合并二尖瓣狭窄,无二尖瓣疾病的左心房血栓很少见。一些作者报道了CT和超声心动图的作用,但我们无法从术前影像得出精确诊断。