scholarly journals Infiltrating Cardiac Synovial Sarcoma Presenting as Acute Cerebrovascular Accident

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Kelechukwu U. Okoro ◽  
Matthew D. Roby ◽  
David C. Sane ◽  
Robert E. Budin
Keyword(s):  
Synovial Sarcoma ◽  
Surgical Excision ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
High Morbidity ◽  
Rare Manifestation ◽  
Left Ventricular Outflow ◽  
Primary Cardiac Sarcoma ◽  
Cardiac Synovial Sarcoma

Primary cardiac sarcoma is a rare malignant myocardial neoplasm that does not exhibit gender predominance or age predilection. The classification of these tumors includes several subtypes, of which synovial sarcoma is a rare manifestation. When present, these tumors portend a poor prognosis with high morbidity and mortality that is attributable to their inherent infiltrative capacity, especially in the absence of treatment. The general consensus for treatment is surgical excision and neoadjuvant chemotherapy and radiotherapy. In this report, a case of synovial sarcoma involving the left ventricular outflow tract and aortic valve is presented.

Primary Cardiac Synovial Sarcoma Originating from the Mitral Valve Causing Left Ventricular Outflow Tract Obstruction

2015 ◽  
Vol 18 (3) ◽  
pp. 112 ◽  
Author(s):  
Altin Veshti ◽  
Edvin Mihal Prifti ◽  
Majlinda Ikonomi
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Synovial Sarcoma ◽  
Surgical Excision ◽  
Radical Resection ◽  
Ventricular Outflow Tract ◽  
Small Mass ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Cardiac Synovial Sarcoma

An 11-year-old boy was admitted due to different episodes of syncope and convulsion. Echocardiogram revealed a mass of 2 × 4 cm originating from the mitral subvalvular apparatus and more precisely from the antero-lateral papillary muscle, protruding in the left ventricle outflow tract causing intermittent obstruction. The patient underwent surgical excision of the left sided mass. Pathology confirmed the diagnosis of primary synovial sarcoma. At 6 months after the operation a small mass in the left ventricle of 1 × 1 cm was detected. The patient underwent reoperation consisting in radical resection of the subvalvular apparatus and mitral valve replacement. Histology confirmed that the mass was a cardiac synovial sarcoma. At 1 year after surgery the patient is doing well.

scholarly journals Asymptomatic Left Ventricular Myxoma in a 12-Year-Old Male

2016 ◽  
Vol 43 (3) ◽  
pp. 267-269 ◽  
Author(s):  
Meghan Chlebowski ◽  
James O'Brien ◽  
Casey Hertzenberg ◽  
Jonathan Wagner
Keyword(s):  
Case Reports ◽  
Cardiac Myxoma ◽  
Surgical Excision ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Cavity ◽  
Complete Surgical Excision ◽  
Left Ventricular Outflow ◽  
Atrial Tumors

Cardiac myxoma is the most common cardiac tumor in patients of all ages; the majority are encountered as single left atrial tumors. Left ventricular myxomas are exceedingly rare, having been recorded in a small number of case reports involving children worldwide. We report a case of a left ventricular myxoma with left ventricular outflow tract obstruction in a previously healthy, asymptomatic adolescent black male. Transthoracic echocardiograms revealed a single, large (2.5 × 5-cm), lobulated, mobile mass within the left ventricular cavity that oscillated into the outflow tract, thereby causing moderate obstruction during systole. Advanced images delineated the location and tissue composition of the mass, characterizing it as a myxoma. Complete surgical excision of the mass was accomplished via aortotomy. Gross examination and histology confirmed the diagnosis of myxoma.

Left Ventricular Outflow Tract Obstruction in patients treated with Milrinone for Cerebral Vasospasm (Preprint)

2021 ◽  
Author(s):  
Charles Baulier ◽  
Marc Lessert ◽  
Jean-Louis Chauvet ◽  
Pauline Garel ◽  
Alexandre Bergis ◽  
...  
Keyword(s):  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Clinical Situation ◽  
Left Ventricular ◽  
Outflow Tract ◽  
High Morbidity ◽  
Ventricular Outflow Tract Obstruction ◽  
Ventricular Afterload ◽  
Left Ventricular Outflow ◽  
Neurological Prognosis

UNSTRUCTURED Subarachnoid hemorrhage is associated with a high morbidity and mortality, and cerebral arterial vasospasm is one of its main complications that determines neurological prognosis. The use of intravenous milrinone is becoming more and more common in the treatment of vasospasm. This molecule has positive inotropic and vasodilating properties by inhibiting phosphodiesterase-3. Its most described side effects are cardiac arrhythmias and arterial hypotension. In this work, we raise new issue concerning milrinone and discuss an undescribed side effect of this treatment, the left ventricular outflow tract obstruction (LVOTO). LVOTO is a clinical situation favored by hypovolemia, decreased left ventricular afterload and excessive inotropism that can lead to severe hemodynamic failure and pulmonary edema. To our knowledge, this is the first work describing milrinone-induced LVOTO. This could compromise cerebral perfusion, and therefore the neurological prognosis of patients. While it is known that catecholamines may induce LVOTO, milrinone-induced LVOTO appears to be a new pathophysiological entity of which neurosurgical intensivists should be aware.

Abstract 13781: Recurrence of Papillary Fibroelastoma

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ahmed Sorour ◽  
Reto Kurmann ◽  
Edward El-Am ◽  
Melanie Bois ◽  
Christopher Scott ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Ventricular Outflow Tract ◽  
Postoperative Recurrence ◽  
Left Ventricular ◽  
Papillary Fibroelastoma ◽  
Published Data ◽  
Surgical Removal ◽  
Left Ventricular Outflow ◽  
Pathologic Analysis

Background: Papillary fibroelastoma (PFE) is the most common benign cardiac tumor. Because PFEs have the potential to embolize, they typically are surgically excised. Prior studies have suggested that postoperative recurrence of PFE is rare or does not occur. Objectives: To determine the rate at which PFEs recurred after surgical removal and to identify any risk factors associated with recurrence. Methods: Patients with pathologically proven PFE were retrospectively identified from a single center. Patients were included in the study if they had an echocardiographic examination at least 1 year after surgery. Echocardiographic images obtained intraoperatively (after excision) and at dismissal were compared with those of the most recent examination to assess the possibility of PFE recurrence. Results: Ninety eight patients were identified. The mean (SD) duration of follow-up was 5.4 (3.7) years (range, 1-17 years). Twelve patients (12.2%) had echocardiographically proven PFE recurrence. Three patients had the recurrent lesion surgically re-excised, and pathologic analysis showed that 2 were recurrent PFEs and 1 was a Lambl excrescence. Clinical presentation of stroke or TIA was more common for the recurrence patients (for the first PFE) than for the nonrecurrence patients (83% vs 26%; P <.001). Conclusions: Contrary to published data, PFEs do recur after surgical excision. This emphasizes the importance of postoperative follow-up with transesophageal echocardiography for identifying recurrent masses. Table. Characteristics of Patients With Recurrent PFE Abbreviations: AV, aortic valve; LA, left atrium; LE, Lambl excrescence; LVOT, left ventricular outflow tract; MV, mitral valve; PV, pulmonary valve; RA, right atrium; RC, right cusp; TV, tricuspid valve. a Corresponds to the same location. b Corresponds to a different location .

Preoperative management of the neonate with critical aortic valvar stenosis

2014 ◽  
Vol 24 (6) ◽  
pp. 1111-1116 ◽  
Author(s):  
Jeremy T. Affolter ◽  
Nancy S. Ghanayem
Keyword(s):  
Aortic Stenosis ◽  
Cardiogenic Shock ◽  
Wall Stress ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Cardiac Catheterisation ◽  
High Morbidity ◽  
Critical Aortic Stenosis ◽  
Organ Systems ◽  
Left Ventricular Outflow

AbstractNeonatal critical aortic stenosis is a rare form of CHD that often presents with cardiogenic shock. Although surgical and cardiac catheterisation-based interventions have been successful in alleviating left ventricular outflow tract obstruction, it remains associated with high morbidity and mortality. Critical aortic stenosis results in elevated left ventricular wall stress, which ultimately increases myocardial oxygen consumption and disrupts coronary artery perfusion during diastole, leading to ventricular dysfunction and cardiogenic shock. Critical care management before definitive intervention should be tailored to optimising oxygen delivery and reducing metabolic consumption of the myocardium and peripheral organ systems. This can be accomplished with prostaglandin infusion to maintain system perfusion through patency of the arterial duct, inotropic support, mechanical ventilation, and central nervous system abrogation. Management should also include a multi-specialty medical team including paediatric cardiothoracic surgeons and paediatric cardiologists with expertise in cardiac catheterisation, imaging, and transplantation.

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