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卵圆孔未闭封堵术后左心房黏液瘤致脑栓塞和非心机梗死原因不明的急性冠状动脉综合征:1 例报告。

Cerebral Embolism and MINOCA Secondary to Left Atrial Myxoma after Occlusion of Atrial Septal Defect by Amplatzer Occluder: A Case Report.

机构信息

Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China; Department of Cardiovascular Medicine, Shanghai East Hospital Ji'an Hospital, 343000 Ji'an, Jiangxi, China.

Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China.

出版信息

Heart Surg Forum. 2024 Jan 9;27(1):E006-E013. doi: 10.59958/hsf.5803.

Abstract

Primary heart tumors are rare, with atrial myxomas being the most common type. Atrial myxomas can lead to embolisms, heart obstruction, and systemic symptoms. Herein, we report a case of 72-year-old woman who presented with a left atrial myxoma at the atrial septal defect occluder, a new acute cerebral infarction, and MINOCA (myocardial infarction with no obstructive coronary atherosclerosis). Left atrial myxoma is a common primary cardiac tumor; however, left atrial myxomas arising after percutaneous atrial septal defect occlusion are rare. Additionally, the patient presented with a new case of multiple systemic emboli. The patient underwent surgical resection of a left atrial myxoma, occluder, and left atrium, and atrial septal repair, and was discharged with good recovery for outpatient follow-up. The possibility of a cardiac tumor, especially an atrial myxoma, which can lead to a series of complications, should be considered at the closure site after percutaneous atrial septal closure. Therefore, active surgical treatment and long-term follow-up are warranted in such cases.

摘要

原发性心脏肿瘤较为罕见,其中心房黏液瘤最为常见。心房黏液瘤可导致栓塞、心脏阻塞和全身症状。本文报告了 1 例 72 岁女性患者,其在房间隔缺损封堵器处发生左心房黏液瘤,伴新发急性脑梗死和 MINOCA(非阻塞性冠状动脉粥样硬化性心肌梗死)。左心房黏液瘤是一种常见的原发性心脏肿瘤;然而,经皮房间隔缺损封堵术后发生左心房黏液瘤较为罕见。此外,该患者还出现了新的多发性系统性栓塞。该患者接受了左心房黏液瘤、封堵器和左心房切除术以及房间隔修补术,出院时恢复良好,可进行门诊随访。在经皮房间隔闭合后,应考虑到心脏肿瘤(尤其是心房黏液瘤)的可能性,其可导致一系列并发症。因此,此类情况下应行积极的手术治疗和长期随访。

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