Bhagia Geeta, Hussain Nasir, Arty Fnu, Chakravarthy Mithun, Shah Moneal
Rochester General Hospital, Rochester, USA.
UHS Wilson Medical Center, Johnson City, USA.
Eur J Case Rep Intern Med. 2024 May 22;11(6):004519. doi: 10.12890/2024_004519. eCollection 2024.
Atypical myxoma has been reported in various locations in the heart, however, myxoma involving the pulmonary valve is rare. Here we present a case of pulmonic valve myxoma which was resected via a percutaneous approach.
A 66-year-old female with known metastatic adenocarcinoma of the lung, and chronic obstructive pulmonary disease presented with acute onset shortness of breath for two days. The patient experienced respiratory arrest en-route to the hospital and required intubation. Computed tomography angiography (CTA) of the chest revealed a new 1.4 × 1.6 cm intracardiac mass along the pulmonary valve. Further evaluation with cardiac magnetic resonance imaging revealed it to be a large vascular tumor on the ventricular side of the pulmonary valve, attached with a narrow stalk. Due to high surgical risk, the patient underwent transesophageal echocardiographic guided percutaneous removal of the mass. Pathology confirmed the mass to be a myxoma.
Atypical myxoma should be considered in the differential diagnosis of valvular masses. Percutaneous resection of valvular masses may be feasible in high-risk surgical patients.
Pulmonary valve myxoma is a rare condition and the literature on the characteristics and treatment options for pulmonary valve myxoma is limited.Our patient was treated with a minimally invasive treatment approach: removal of a tumor with intra operative transesophageal echocardiographic guidance using AngioVac and Flow Triever catheters.Percutaneous resection of valvular masses may be feasible in high surgical risk patients.
非典型黏液瘤已在心脏的各个部位被报道，然而，累及肺动脉瓣的黏液瘤罕见。在此，我们报告一例经皮途径切除的肺动脉瓣黏液瘤病例。
一名66岁女性，已知患有肺转移性腺癌和慢性阻塞性肺疾病，因急性发作气短两天就诊。患者在前往医院途中发生呼吸骤停，需要插管。胸部计算机断层扫描血管造影（CTA）显示沿肺动脉瓣有一个新的1.4×1.6 cm心内肿块。心脏磁共振成像进一步评估显示，它是一个位于肺动脉瓣心室侧的大型血管肿瘤，附着有一个狭窄的蒂。由于手术风险高，患者接受了经食管超声心动图引导下经皮切除肿块。病理证实肿块为黏液瘤。
在瓣膜肿块的鉴别诊断中应考虑非典型黏液瘤。对于手术风险高的患者，经皮切除瓣膜肿块可能是可行的。
肺动脉瓣黏液瘤是一种罕见疾病，关于肺动脉瓣黏液瘤的特征和治疗选择的文献有限。我们的患者采用了微创治疗方法：使用AngioVac和Flow Triever导管在术中经食管超声心动图引导下切除肿瘤。对于手术风险高的患者，经皮切除瓣膜肿块可能是可行的。
