Clinical Characteristics of Acute Lower Extremity Ischemia Due to Left Atrial Myxoma: A Rare Case Report with Review of Literature.

IF 0.7 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Heart Surgery Forum Pub Date : 2023-06-29 DOI:10.59958/hsf.5607
Haimeng Zhou, Yanhuan Yin, Zhihuan Sun
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Abstract

Emboli caused by cardiac myxomas mostly occur in the cardiovascular or cerebrovascular systems and rarely in the lower extremity vasculature. We introduce the rare case of a patient with left atrial myxoma (LAM) whose right lower extremity (RLE) suffered from acute ischemia due to tumor fragments, along with a review of the relevant literature, and highlight the clinical characteristics of LAM. An 81-year-old female presented with acute ischemia of RLE. Color Doppler ultrasound showed no blood flow signal far from the RLE femoral artery. Computed tomography angiography showed an occlusion of the right common femoral artery. A transthoracic echocardiogram revealed a left atrial mass. Femoral artery embolectomy was performed under local anesthesia, followed by thoracotomy with tumor resection under general anesthesia on postoperative day seven. The tumor was pathologically confirmed as an atrial myxoma. A literature search of the PubMed database returned 58 cases of limb ischemia due to LAM, and the conclusions drawn from the statistical analysis were that emboli from LAM occurred most commonly in the aortoiliac and bilateral lower limb vasculature and were rarely associated with upper extremity and atrial fibrillation. Multisystem embolism is characteristic of cardiac myxoma. The removed embolus should be examined pathologically for signs of a cardiac myxoma. Lower-limb embolisms should be promptly diagnosed and treated to avoid osteofascial compartment syndrome.

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左心房黏液瘤致急性下肢缺血的临床特点:一例罕见病例报告并文献复习。
心脏黏液瘤引起的栓子多发生在心脑血管系统,很少发生在下肢血管系统。我们介绍一例罕见的左心房黏液瘤(LAM)患者,右下肢因肿瘤碎片急性缺血,并复习相关文献,并强调LAM的临床特点。一位81岁女性,表现为RLE急性缺血。彩色多普勒超声显示远侧股动脉无血流信号。计算机断层血管造影显示右侧股总动脉闭塞。经胸超声心动图显示左心房肿块。局部麻醉下行股动脉栓塞切除术,术后第7天全麻下开胸切除肿瘤。病理证实为心房黏液瘤。文献检索PubMed数据库,检索到58例LAM所致肢体缺血病例,统计分析得出LAM所致栓塞最常见于髂主动脉和双侧下肢血管,很少与上肢和房颤相关。多系统栓塞是心脏黏液瘤的特征。切除的栓子应进行病理检查,以寻找心脏黏液瘤的迹象。下肢栓塞应及时诊断和治疗,以避免骨筋膜室综合征。
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来源期刊
Heart Surgery Forum
Heart Surgery Forum 医学-外科
CiteScore
1.20
自引率
16.70%
发文量
130
审稿时长
6-12 weeks
期刊介绍: The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.
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