Suzue T, Sawayama Y, Suzuki T, Nakagawa Y. A rapidly growing cardiac calcified amorphous tumour diagnosed after coronary artery bypass graft surgery: a case report.
EUROPEAN HEART JOURNAL-CASE REPORTS 2021;
5:ytab243. [PMID:
34423238 PMCID:
PMC8374977 DOI:
10.1093/ehjcr/ytab243]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/08/2021] [Accepted: 05/25/2021] [Indexed: 12/04/2022]
Abstract
Background
A cardiac calcified amorphous tumour (CAT) is a non-neoplastic intracavitary cardiac mass. The most serious complication is systemic embolism. Cardiac CATs tend to be surgically resected immediately after detection; therefore, its progress of growth is rarely reported.
Case summary
An 83-year-old Japanese woman received on-pump beating coronary artery bypass graft surgery (CABG) for angina pectoris. Transthoracic echocardiography (TTE) performed preoperatively and 1 month postoperatively revealed the presence of mitral annular calcification, with no other abnormal findings. However, follow-up TTE performed 5 months after CABG revealed a mobile nodular mass (5.0 × 8.2 mm) in the left ventricular outflow tract. At 1 month after detection, the mass had enlarged to 5.0 × 13.0 mm. Transoesophageal echocardiography revealed that the pedunculated high-echoic mass was adhered to the posterior commissure of the mitral valve and was dynamically swinging towards the non-coronary cusp in the systolic phase. As the mass had grown rapidly in less than 6 months, it was surgically resected to prevent systemic embolism. The histological specimen consisted mainly of fibrin, including calcification and hemosiderin deposition, which lead to a diagnosis of cardiac CAT. The patient had an uneventful postoperative course during her hospital stay and had no evidence of recurrence for 1 year after discharge.
Discussion
This was a rare case in which a rapidly growing cardiac CAT was detected following on-pump CABG. Cardiac CATs may grow very rapidly and therefore early surgery should be considered after initial diagnosis.
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