Key result
Delayed resection of left atrial myxoma 4 weeks post-stroke yields uneventful recovery with no residual MR.
Why the study?
Neurologic complications from cardiac myxomas are common, and the timing of surgery after embolic stroke to reduce hemorrhagic risk from cardiopulmonary bypass anticoagulation is unclear.
Case Report (n=1)
Delaying open heart surgery for 4 weeks after an embolic stroke from an atrial myxoma may safely reduce the risk of hemorrhagic conversion during cardiopulmonary bypass, while intraoperative TEE is crucial for detecting newly unmasked mitral regurgitation.
May support delayed myxoma resection after stroke; leaves open need for prospective validation.
A 36-year-old male involved in a car accident was found to have an embolic stroke due to a left atrial myxoma. Open heart surgery was delayed 4 weeks to decrease the risk of neurologic complications from the anticoagulation required for cardiopulmonary bypass. After resection of the myxoma, intraoperative transesophageal echocardiography found severe mitral regurgitation, which was repaired.
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Hirose et al. (2008) conducted a case report in Left atrial myxoma with embolic stroke and severe mitral regurgitation (n=1). Delayed surgical resection and mitral valve annuloplasty was evaluated on Postoperative recovery and residual mitral regurgitation. Delayed surgical resection of a left atrial myxoma 4 weeks after an embolic stroke, combined with mitral valve annuloplasty, resulted in successful tumor removal, no residual mitral regurgitation, and an uneventful recovery.
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