Gupta Dipin, Molina Ezequiel, Palma Jon, Macha Mahender
Temple University Hospital, Philadelphia, PA 19140, USA.
Heart Vessels. 2006 Jul;21(4):256-7. doi: 10.1007/s00380-005-0866-0.
A 65-year-old man presented to the emergency room following an episode of syncope. His vital signs and physical examination were unremarkable. A chest X-ray and an ECG were also normal. He was admitted to the hospital for further work-up. A computed tomography scan of his brain did not reveal any evidence of stroke, hemorrhage, or mass effect. A transesophageal echocardiogram, however, revealed tricuspid regurgitation and a right atrial mass with finger-like projections, which appeared to originate from the tricuspid valve. Left heart catheterization was performed, showing a 99% proximal right coronary artery stenosis. The patient was scheduled to undergo atrial mass resection, tricuspid valve annuloplasty, and coronary bypass. During the procedure, a large myxoma was found to be adherent to the right side of the atrial septum, adjacent to the fossa ovalis. The mass was friable and was attached to the endocardium by a pedicle. Following resection of the atrial mass and tricuspid valve annuloplasty, a single saphenous vein graft bypass to the right coronary artery was performed. The patient's postoperative course was unremarkable and he was discharged home on postoperative day 6.
一名65岁男性在发生一次晕厥后被送往急诊室。他的生命体征和体格检查均无异常。胸部X光和心电图也正常。他被收住入院作进一步检查。脑部计算机断层扫描未发现任何中风、出血或占位效应的迹象。然而，经食管超声心动图显示三尖瓣反流以及一个有指状突起的右心房肿块，该肿块似乎起源于三尖瓣。进行了左心导管检查，显示右冠状动脉近端狭窄99%。该患者计划接受心房肿块切除术、三尖瓣环成形术和冠状动脉搭桥术。在手术过程中，发现一个大的黏液瘤附着于房间隔右侧，靠近卵圆窝。肿块质地脆，通过蒂附着于心内膜。切除心房肿块并进行三尖瓣环成形术后，进行了单根大隐静脉移植至右冠状动脉的搭桥手术。患者术后恢复过程顺利，术后第6天出院回家。
