Key result
Complex surgical reconstruction of the left heart in a patient with dilated cardiomyopathy and giant left atrial myxoma improved left ventricular ejection fraction from 17% to 23% and reduced left atrial diameter from 7.8 cm to 5.0 cm at discharge.
Case Report (n=1)
No
Complex surgical reconstruction including left atrial reduction and myxoma removal in a patient with advanced dilated cardiomyopathy and left atriomegaly improved early postoperative hemodynamics and morphometry.
Early hemodynamic gains after atrial reduction in dilated cardiomyopathy; hypothesis-generating and leaves open durability plus generalizability.
Case description. A 41-year-old male patient F. was admitted to the Department ofSurgical Treatment of Ac-quired Heart Diseases of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a diagnosis: Dilated cardiomyopathy. Mitral-tricuspid insufϐiciency. Left atrial myxoma. Left atriomegaly. Pulmonary hypertension. The patient was operated with heart failure symptoms of NYHA functional class IV. After a week of medical preparation and additional examination,the patient was successfully operated on (remov-al of the left atrial myxoma, imposition of support rings on the left and right atrioventricular openings, paraanular plicacy of the left atrium). The postoperative period proceededwithout signiϐicant complications. On the 12th day after the operation, the patient was discharged in satisfactorycondition. In the remote period the patient died suddenly 3 years later. Conclusion. Taking into account the initial serious condition of a patient with advanced heart disease with a reduced left ventricular ejection fraction, left atriomegaly (7.8 cm), pulmonary hypertension (50 mm Hg) and comorbidities, complex reconstruction of the left heart in atriomegaly and ventriculomegaly leads to an improvement in the functional state of the myocardium and morphometric indicators of left atrium and left ventricular ejection fraction.
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Попов et al. (2022) conducted a case report in Dilated cardiomyopathy, left atrial myxoma, left atriomegaly, mitral-tricuspid insufficiency (n=1). Surgical removal of left atrial myxoma, atrioventricular support rings, and paraanular plication of the left atrium was evaluated on Echocardiographic parameters (LVEF and LAD) at discharge. Complex surgical reconstruction of the left heart in a patient with dilated cardiomyopathy and giant left atrial myxoma improved left ventricular ejection fraction from 17% to 23% and reduced left atrial diameter from 7.8 cm to 5.0 cm at discharge.
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