Key result
Video-assisted transmitral resection successfully removes a primary LV apex lipoma with 1-year event-free survival.
Case Report (n=1)
Video-assisted transmitral resection is a feasible and effective approach for removing primary cardiac lipomas located in the left ventricular apex without the need for ventriculotomy.
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Multimodality imaging aids LV lipoma diagnosis; single cases leave management and surveillance questions open.
A 77-year-old woman who suffered from weight loss was referred to our hospital. She lost 8 kg of weight a year, and whole-body computed tomography (CT) scan was performed for the evaluation of malignancies. Contrast enhanced CT demonstrated a low-intensity (−100 to −120 Hounsfield) mass without contrast opacification (Panel A). Echocardiography revealed a high echogenic and well-demarcated movable mass (25 × 28 mm) located in the left ventricular apex (Panel B, arrow; see Supplementary data online, Video S1). T2 and fat suppression T2 magnetic resonance imaging suggested that the tumour was a lipoma (Panels C and D, arrow). Transmitral endoscopy via the left atrium demonstrated the yellowish and well-demarcated mass originating from the left ventricular wall (Panel E, arrow; see Supplementary data online, Video S2). Intraoperative consultation revealed that the tumour was a lipoma without malignancy (Panel F), which was completely resected by transmitral approach without ventriculotomy. The patient was event free with no relapse for at least a year.
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Tanaka et al. (2015) conducted a case report in Primary cardiac lipoma (n=1). Video-assisted transmitral resection was evaluated on Event free with no relapse. Video-assisted transmitral resection successfully removed a primary cardiac lipoma originating from the left ventricular apex, with the patient remaining event-free for at least a year.
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