1
|
D'Anna L, Abu-Rumeileh S, Merlino G, Ornello R, Foschi M, Diana F, Barba L, Mastrangelo V, Romoli M, Lobotesis K, Bax F, Kuris F, Valente M, Otto M, Korompoki E, Sacco S, Gigli GL, Nguyen TN, Banerjee S. Safety and Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Attributable to Cardiological Diseases: A Scoping Review. J Am Heart Assoc 2024; 13:e034783. [PMID: 38874062 DOI: 10.1161/jaha.124.034783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
There is limited evidence on the outcomes and safety of mechanical thrombectomy (MT) among patients with acute ischemic stroke (AIS) in the context of cardiac diseases. Our study reviews MT in AIS within the context of cardiac diseases, aiming to identify existing and emerging needs and gaps. PubMed and Scopus were searched until December 31, 2023, using a combination of cardiological diseases and "mechanical thrombectomy" or "endovascular treatment" as keywords. Study design included case reports/series, observational studies, randomized clinical trials, and meta-analyses/systematic reviews. We identified 943 articles, of which 130 were included in the review. Results were categorized according to the cardiac conditions. MT shows significant benefits in patients with atrial fibrillation (n=139) but lacks data for stroke occurring after percutaneous coronary intervention (n=2) or transcatheter aortic valve implantation (n=5). MT is beneficial in AIS attributable to infective endocarditis (n=34), although functional benefit may be limited. Controversy surrounds the functional outcomes and mortality of patients with AIS with heart failure undergoing MT (n=11). Despite technical challenges, MT appears feasible in aortic dissection cases (n=4), and in patients with left ventricular assist device or total artificial heart (n=10). Data on AIS attributable to congenital heart disease (n=4) primarily focus on pediatric cases requiring technical modifications. Treatment outcomes of MT in patients with cardiac tumors (n=8) vary because of clot consistency differences. After cardiac surgery stroke, MT may improve outcomes with early intervention (n=13). Available data outline the feasibility of MT in patients with AIS attributable to large-vessel occlusion in the context of cardiac diseases.
Collapse
Affiliation(s)
- Lucio D'Anna
- Department of Stroke and Neuroscience Charing Cross Hospital, Imperial College London NHS Healthcare Trust London United Kingdom
- Department of Brain Sciences Imperial College London London United Kingdom
| | - Samir Abu-Rumeileh
- Department of Neurology Martin-Luther-University Halle-Wittenberg Halle (Saale) Germany
| | - Giovanni Merlino
- Stroke Unit and Clinical Neurology Udine University Hospital Udine Italy
| | - Raffaele Ornello
- Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy
| | - Matteo Foschi
- Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy
| | - Francesco Diana
- Interventional Neuroradiology Vall d'Hebron University Hospital Barcelona Catalunya Spain
| | - Lorenzo Barba
- Department of Neurology Martin-Luther-University Halle-Wittenberg Halle (Saale) Germany
| | | | - Michele Romoli
- Neurology and Stroke Unit, Department of Neuroscience Bufalini Hospital, Azienda Unità Sanitaria Locale Romagna Cesena Italy
| | - Kyriakos Lobotesis
- Neuroradiology, Department of Imaging, Charing Cross Hospital, Imperial College London NHS Healthcare Trust London United Kingdom
| | - Francesco Bax
- Philip Kistler Research Center, Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston MA USA
| | - Fedra Kuris
- Stroke Unit and Clinical Neurology Udine University Hospital Udine Italy
| | - Mariarosaria Valente
- Clinical Neurology Udine University Hospital and Dipartmento di Area Medica, University of Udine Udine Italy
| | - Markus Otto
- Department of Neurology Martin-Luther-University Halle-Wittenberg Halle (Saale) Germany
| | - Eleni Korompoki
- Department of Brain Sciences Imperial College London London United Kingdom
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy
| | - Gian Luigi Gigli
- Stroke Unit and Clinical Neurology Udine University Hospital Udine Italy
| | - Thanh N Nguyen
- Department of Neurology, Radiology Boston Medical Center Boston MA USA
| | - Soma Banerjee
- Department of Stroke and Neuroscience Charing Cross Hospital, Imperial College London NHS Healthcare Trust London United Kingdom
- Department of Brain Sciences Imperial College London London United Kingdom
| |
Collapse
|
2
|
Riad M, Rahman MU, Mulyala R, Sayyed N, Bayer D, Omar B. Percutaneous Intracardiac Mass Extraction in High Surgical-Risk Patients. J Med Cases 2023; 14:362-368. [PMID: 38029057 PMCID: PMC10681765 DOI: 10.14740/jmc4150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Large intracardiac masses including tumors, thrombi, and vegetations result in detrimental embolic or obstructive sequelae and present a management dilemma. Open heart surgery, the traditional approach, may not be an option for many patients with a prohibitive surgical risk due to multiple comorbidities. Recently, percutaneous options have emerged with reported success in extracting such intracardiac masses. A 42-year-old female with history of advanced primary sclerosing cholangitis with decompensated liver cirrhosis causing ascites and variceal bleed presented to the emergency department with fatigue, subjective fevers, chills and melena. Laboratory results revealed neutrophil-predominant leukocytosis and normocytic anemia, and blood cultures were positive for Candida albicans. Electrocardiography showed sinus tachycardia. Chest X-ray was unremarkable. She underwent packed red blood cell transfusion and esophageal banding for variceal bleeding. Transthoracic echocardiogram revealed normal left ventricular ejection fraction and no wall motion abnormalities. A right atrial mobile mass measuring approximately 1.0 × 3.0 cm was noted. Multidisciplinary heart team discussion concluded that while the mass posed a high embolic risk, the patient had a prohibitive risk for surgical intervention. Successful percutaneous removal of the mass using Penumbra system device (Penumbra Incorporated, Alameda, CA) was accomplished. This case report details the procedure and outcomes, as well as presents a literature review.
Collapse
Affiliation(s)
- Mariam Riad
- Cardiology Division, University of South Alabama, Mobile, AL 36617, USA
| | | | | | - Nadia Sayyed
- Department of Internal Medicine, Khyber Medical College, Peshawar, Pakistan
| | - Danielle Bayer
- Cardiology Division, University of South Alabama, Mobile, AL 36617, USA
| | - Bassam Omar
- Cardiology Division, University of South Alabama, Mobile, AL 36617, USA
| |
Collapse
|
3
|
Choi JH, Park W, Park JC, Ahn JS. Cerebral Myxomatous Aneurysms: Case Series and Systematic Review of Literature with Adequate Follow-Up Periods and Aneurysmal Wall Biopsy Results. World Neurosurg 2023; 172:e107-e119. [PMID: 36566979 DOI: 10.1016/j.wneu.2022.12.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cerebral myxomatous aneurysms (CMA) are intracranial aneurysms caused by cardiac myxoma. The exact mechanism underlying their development has not yet been elucidated. And an optimal treatment method has not yet been established because of rarity of the disease. In addition, most existing reports have had a short follow-up period or lack of follow-up imaging test results. The aim of this study was to provide better insights into the course and treatment options of CMAs. METHODS We describe 4 CMA patients treated in our hospital and literature search was performed using PubMed and Embase databases. Keywords used were as follows: "cerebral myxomatous aneurysm", "myxomatous aneurysm", "cardiac myxoma", and "intracranial aneurysm". Only publications in English and related to this disorder with adequate follow-up periods and aneurysmal wall biopsy results were included. Clinical, radiological, pathological, and treatment characteristics were analyzed. RESULTS A total of 149 CMA cases were managed conservatively that included 9 enlargements, 6 regressions, and 134 stable aneurysms, which were identified for a total of 453.33 aneurysm years (1.91% per aneurysm year, 1.27% per aneurysm year, and 28.76% per aneurysm year, respectively). Poor outcome rate was high in cases with hemorrhage (either parenchymal or subarachnoidal hemorrhage) due to rupture of the CMA (46.67%, 7 out of 15). Thirteen cases had aneurysm biopsy results of which 11 showed tumor invasion on the aneurysm wall. CONCLUSIONS Even though the natural course of unruptured, benign-looking CMAs appears to be favorable, the presence or absence of viable tumor cells in the aneurysm may promote an unfavorable disease course. In the case of large, symptomatic, and enlarging CMAs, surgical, endovascular, or combined treatment should be considered as the mortality and morbidity due to rupture might be high.
Collapse
Affiliation(s)
- June Ho Choi
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Wonhyoung Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Cheol Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Sung Ahn
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| |
Collapse
|
4
|
Salem M, Hillmer J, Friedrich C, Panholzer B, Saad M, Salem M, Frank D, Ernst M, Maetzler W, Puehler T, Lutter G, Schoeneich F, Haneya A, Cremer J, Schoettler J. Cardiac Myxomas Resembling Malignant Neoplasia: Incidentally Diagnosed vs. Cerebral Embolized Myxomas. Cancers (Basel) 2022; 14:cancers14051111. [PMID: 35267419 PMCID: PMC8909683 DOI: 10.3390/cancers14051111] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Cardiac myxomas (CM) are the most common primary cardiac tumors in adults. They are usually benign; however, malignant changes are known to occur but are extremely rare. Embolization is a common complication of cardiac myxomas and can cause neurological deficits before their surgical removal. The current study analyzed the outcomes after operative myxoma excision in patients, with and without cerebral embolic events prior to excision. Methods: All 66 consecutive patients who underwent a surgical excision of CM between 2005 and 2019 at our department were analyzed retrospectively. Patients with (n = 14) and without (n = 52) preoperative strokes caused by cerebral tumor embolization were compared. Results: The mean age was 58.4 ± 12.7 years in the stroke group (SG) and 62.8 ± 11.7 years in the non-stroke group (N-SG) (p = 0.226). Gender (35.7% vs. 61.5% female; p = 0.084) did not differ significantly, and comorbidities were comparable in both groups. The left hemisphere in the territory of the middle cerebral artery was affected by preoperative cerebral infarction most commonly (28.6%). The time from diagnosis to cardiac surgery procedure was 7 (3−24) days in the SG and 23 (5−55) days in the N-SG (p = 0.120). Cardiac myxomas were localized in the left atrium in both groups more frequently (SG: 92.9% vs. N-SG: 78.8%; p = 0.436). In the SG, 57.1% of CM had a non-solid surface, were localized in the left heart, and had a pedunculated attachment away from the fossa ovalis. In the N-SG, 92.3% of CM did not meet all these criteria (p < 0.001). The maximal diameters of CM were comparable (SG: 3.4 ± 1.5 cm vs. N-SG: 3.8 ± 2.1 cm; p = 0.538). The operation times (192.5 (139.3−244.5) min vs. 215.5 (184.5−273.3) min; p = 0.046) and the cross-clamp times (54.5 (33.3−86.5) min vs. 78.5 (55−106.8) min; p = 0.035) were significantly shorter in the SG. Only in the N-SG were reconstructions of the endocardium with bovine pericardium required after resection (51.9% vs 0%; p < 0.001). In the N-SG, CM were explored via the right atrium more often (57.7% vs. 14.3%; p = 0.007). Patients in the N-SG required significantly shorter ICU care after surgery (p = 0.020). Other postoperative courses did not differ significantly. After tumor removal, 1.9% of the N-SG suffered their first stroke and 14.3% of the SG had a cerebral re-infarction (p = 0.111). The 30-day mortality rates were 1.9% in the N-SG and 7.1% in the SG (p = 0.382). In one case in the N-SG, a tumor recurrence was diagnosed. The Kaplan−Meiercurves showed a significantly better long-term prognosis for patients in the N-SG (p = 0.043). Conclusions: After the surgical removal of CM, the outcome is compromised if preoperative cerebral embolization occurs. Surgical treatment is therefore indicated as soon as possible, especially when CM have a non-solid surface, are localized in the left heart, and have a pedunculated attachment away from the fossa ovalis.
Collapse
Affiliation(s)
- Mohamed Salem
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
- Correspondence: ; Tel.: +49-(0431)-500-67089; Fax: +49-(0431)-500-22004
| | - Jonas Hillmer
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
| | - Christine Friedrich
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
| | - Bernd Panholzer
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
| | - Mohammed Saad
- Department of Cardiology and Angiology, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (M.S.); (M.S.); (D.F.)
| | - Mostafa Salem
- Department of Cardiology and Angiology, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (M.S.); (M.S.); (D.F.)
| | - Derk Frank
- Department of Cardiology and Angiology, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (M.S.); (M.S.); (D.F.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Potsdamer Str. 58, 10785 Berlin, Germany
| | - Markus Ernst
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
| | - Walter Maetzler
- Department of Neurology, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany;
| | - Thomas Puehler
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Potsdamer Str. 58, 10785 Berlin, Germany
| | - Georg Lutter
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Potsdamer Str. 58, 10785 Berlin, Germany
| | - Felix Schoeneich
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
| | - Assad Haneya
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
| | - Jochen Cremer
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
| | - Jan Schoettler
- Department of Cardiovascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.H.); (C.F.); (B.P.); (M.E.); (T.P.); (G.L.); (F.S.); (A.H.); (J.C.); (J.S.)
| |
Collapse
|
5
|
Mak G, Lu JQ, Perera K. Histopathologic analysis of retrieved cerebral thrombi in acute ischemic stroke patients with proximal anterior circulation occlusions amenable to endovascular thrombectomy. J Neurol Sci 2021; 429:117617. [PMID: 34461551 DOI: 10.1016/j.jns.2021.117617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/06/2021] [Accepted: 08/13/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Gloria Mak
- McMaster University, Department of Medicine, Hamilton Health Science, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
| | - Jian-Qiang Lu
- McMaster University, Department of Pathology and Molecular Medicine, Hamilton Health Science, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
| | - Kanjana Perera
- McMaster University, Department of Medicine, Population Health Research Institute, C4-106, 30 Copeland Avenue, Hamilton, Ontario L8L 2X2., Canada.
| |
Collapse
|
6
|
Dong M, Ge Y, Li J, Fu K, Zhang L, Teng W, Tian L. Intravenous thrombolysis for pure pontine infarcts caused by cardiac myxoma: a case report and literature review. Int J Neurosci 2019; 130:635-641. [PMID: 31818173 DOI: 10.1080/00207454.2019.1702537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: Cardiac myxoma (CM) is a rare but important cause of ischemic stroke, and typically involves the middle cerebral artery and rarely affects the brainstem only. The safety and efficacy of intravenous thrombolysis (IVT) for CM-related acute cerebral embolism are not clear.Methods: We report a case of a 55-year-old woman who suffered a CM-related acute cerebral embolism presented with pure pontine infarcts and achieved a favorable prognosis by IVT with urokinase. We summarized the clinical data of this entity and performed a literature review of 21 previous reports of patients with CM-related acute cerebral embolism who were treated with IVT.Results: In combination with previous reports, we found that the majority of patients (81.8%) obtained improvements in symptoms after IVT, including 63.6% in remarkable clinical improvement. The total rate of IVT-induced intracerebral hemorrhage was 22.7% and all occurred within 36 h, including hemorrhagic infarction type 1 (4.5%) and parenchymal hematoma type 2 (18.2%). Most of the cases had relatively good outcomes and no case died due to IVT.Conclusion: Taken together, our findings support the use of IVT as an effective and safe tool for the ultra-early treatment of CM-related acute phase ischemic stroke.
Collapse
Affiliation(s)
- Mingming Dong
- Department of Neurology, The Fourth People's Hospital of Shenyang, Shenyang, China
| | - Yusong Ge
- Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jinwei Li
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Kailei Fu
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Liyang Zhang
- Department of Neurology, The Fourth People's Hospital of Shenyang, Shenyang, China
| | - Weiyu Teng
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Li Tian
- Department of Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
7
|
|
8
|
Kargiotis O, Psychogios K, Safouris A, Magoufis G, Zervas PD, Stamboulis E, Tsivgoulis G. The Role of Transcranial Doppler Monitoring in Patients with Multi‐Territory Acute Embolic Strokes: A Review. J Neuroimaging 2019; 29:309-322. [DOI: 10.1111/jon.12602] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 12/19/2022] Open
Affiliation(s)
| | | | - Apostolos Safouris
- Stroke UnitMetropolitan Hospital Piraeus Greece
- Second Department of NeurologyNational & Kapodistiran University of Athens, School of Medicine, “Attikon” University Hospital Athens Greece
| | | | - Paschalis D. Zervas
- Second Department of NeurologyNational & Kapodistiran University of Athens, School of Medicine, “Attikon” University Hospital Athens Greece
| | | | - Georgios Tsivgoulis
- Second Department of NeurologyNational & Kapodistiran University of Athens, School of Medicine, “Attikon” University Hospital Athens Greece
- Department of NeurologyThe University of Tennessee Health Science Center Memphis TN
| |
Collapse
|
9
|
Moreno-Estébanez A, Luna Rodríguez A, Ugarriza Serrano I, Blanco Martín E, González-Pinto T, Larrazabal López J, Pérez-Concha T. Papillary fibroelastoma, an unexpected cause of stroke: Outcomes after acute reperfusion therapy. Neurol Clin Pract 2018; 8:e4-e6. [PMID: 30105169 DOI: 10.1212/cpj.0000000000000455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 02/15/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Ana Moreno-Estébanez
- Departments of Neurology (AM-E, ALR, IUS, EBM, TG-P, TP-C) and Cardiology (JLL), Cruces University Hospital, Barakaldo, Basque Country, Spain
| | - Alain Luna Rodríguez
- Departments of Neurology (AM-E, ALR, IUS, EBM, TG-P, TP-C) and Cardiology (JLL), Cruces University Hospital, Barakaldo, Basque Country, Spain
| | - Iratxe Ugarriza Serrano
- Departments of Neurology (AM-E, ALR, IUS, EBM, TG-P, TP-C) and Cardiology (JLL), Cruces University Hospital, Barakaldo, Basque Country, Spain
| | - Elisa Blanco Martín
- Departments of Neurology (AM-E, ALR, IUS, EBM, TG-P, TP-C) and Cardiology (JLL), Cruces University Hospital, Barakaldo, Basque Country, Spain
| | - Tirso González-Pinto
- Departments of Neurology (AM-E, ALR, IUS, EBM, TG-P, TP-C) and Cardiology (JLL), Cruces University Hospital, Barakaldo, Basque Country, Spain
| | - Jagoba Larrazabal López
- Departments of Neurology (AM-E, ALR, IUS, EBM, TG-P, TP-C) and Cardiology (JLL), Cruces University Hospital, Barakaldo, Basque Country, Spain
| | - Tomás Pérez-Concha
- Departments of Neurology (AM-E, ALR, IUS, EBM, TG-P, TP-C) and Cardiology (JLL), Cruces University Hospital, Barakaldo, Basque Country, Spain
| |
Collapse
|
10
|
Connolly B, Prowse SJ, Connolly CE, Brett NJ. Heart or head?: A depression mimic delays diagnosis-oncotic cerebral aneurysms caused by atrial myxoma. BJR Case Rep 2017; 3:20170028. [PMID: 30363234 PMCID: PMC6159180 DOI: 10.1259/bjrcr.20170028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/04/2017] [Accepted: 05/23/2017] [Indexed: 11/16/2022] Open
Abstract
Complications of intracardiac tumours can carry significant morbidity and mortality. This article depicts the case of a female who presented with multiple oncotic intracranial aneurysms secondary to a left atrial myxoma. The clinical manifestations and pathogenesis of cardiac myxoma, as well as the imaging pathway, management and prognosis of myxomatous aneurysms will be discussed. Excision of the cardiac mass is mandatory both for symptomatic improvement and to prevent further embolic complications. Local recurrence and delayed onset cerebral complications do occur, and necessitate ongoing patient follow-up. Our report highlights several important features of the diagnostic and treatment pathway for atrial myxoma-in particular, the potentially non-specific clinical presentation, the pivotal role of cardiac MRI in the multimodality diagnostic imaging work up and the need for multidisciplinary communication to identify the diagnosis and guide appropriate management.
Collapse
Affiliation(s)
- Bridgid Connolly
- Radiology Department, Flinders Medical Centre, Adelaide, South Australia
| | - Simon J Prowse
- Department of Radiology, Royal Adelaide Hospital, Adelaide, South Australia
| | | | - Nicholas J Brett
- Department of Radiology, Royal Adelaide Hospital, Adelaide, South Australia
| |
Collapse
|
11
|
Zachura M, Kurzawski J, Urbaniak A, Piątek Ł, Janion M. Myxoma Originating From the Anterior Mitral Valve Leaflet in a Young Patient With Neurological Manifestations. Heart Lung Circ 2017; 26:e29-e31. [PMID: 28118960 DOI: 10.1016/j.hlc.2016.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/26/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Małgorzata Zachura
- 2(nd) Department of Cardiology, Świętokrzyskie Cardiology Center, Kielce, Poland.
| | - Jacek Kurzawski
- 2(nd) Department of Cardiology, Świętokrzyskie Cardiology Center, Kielce, Poland
| | | | - Łukasz Piątek
- 2(nd) Department of Cardiology, Świętokrzyskie Cardiology Center, Kielce, Poland
| | - Marianna Janion
- 2(nd) Department of Cardiology, Świętokrzyskie Cardiology Center, Kielce, Poland; Faculty of Medicine and Health Science, Jan Kochanowski University, Kielce, Poland
| |
Collapse
|