cox-maze-iv-procedure-concomitant-with-valvular-surgery-situs

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Atrial fibrillation (AF) is the most common cardiac arrhythmia. The use of ablation technologies made the Cox-Maze IV procedure (CMP-IV) technically ...

Central South University

A case of primary cardiac leiomyoma arising from the infundibulum of the right ventricle of a 24-year-old woman is presented. The mass protruded into the cavity of the right ventricle and caused severe right ventricular outflow tract obstruction. We resected the tumor under cardiopulmonary bypass successfully, and confirmed it histologically to be a benign leiomyoma. To the authors' knowledge, this is the first case report of a primary cardiac leiomyoma in an adult woman. 

Primary leiomyoma: a rare space occupying lesion in the right ventricle.

Atrial fibrillation (AF) is a highly prevalent condition associated with high morbidity and mortality that can cause or exacerbate heart failure and is an important risk factor for stroke. AF is the disorganized propagation of electrical activity in the atrium, which prevents organized contractions. However, the effect of microRNAs and the patterns of the regulatory network of AF remain vague.

MicroRNA Regulatory Network Revealing the Mechanism of Inflammation in Atrial Fibrillation.

To summarize the clinical data of patients who experienced cryoablation in minimally invasive mitral valve surgery and to explore safety and effectiveness of the surgery. 

[Application of cryoablation in  minimally invasive mitral valve surgery].

Left atrial appendage aneurysm is an infrequent abnormality presenting as atrial tachyarrhythmias, progressive dyspnoea, atypical chest pain and systemic thromboembolism. Surgical excision is considered to prevent fatal complications, even in asymptomatic cases. We describe the case of a 44-year-old woman with a history of acute cerebral infarction caused by emboli from a giant left atrial appendage aneurysm, which is the largest one reported to date. Histopathology and Masson staining confirmed the final diagnosis.

Left atrial appendage aneurysm.

Coronary insufficiency caused by unruptured left sinus of Valsalva aneurysm (SVA) is exceedingly rare in the literature. Herein, we present a successful surgically treated case of giant left SVA with severe aortic regurgitation and coronary insufficiency, thus introducing a tailored valve-sparing aortic root repair technique.

Surgical Management of a Giant Left Sinus of Valsalva Aneurysm with Coronary Artery Abnormality.

Cardiac myxomas, primarily originating from the left atrium, are the most prevalent types of benign cardiac tumors; however, biatrial myxomas are extremely rare. Herein, we present a rare case of a 55-year old male with exertional dyspnea and intermittent chest discomfort due to a giant biatrial mass with concomitant atrial fibrillation and hepatic hemangioma. The giant tumor with its peduncle at the interatrial septum involved both atria; however, bulging through the tricuspid valve to the right ventricle during systole. Hence, excision of the giant cardiac tumor (which grossly composed of three parts: stiff, fleshy, and soft) and Cox-Maze IV procedure was performed with the resected specimen measuring 100 × 80 × 40 mm. The patient who was in a stable condition was discharged home on the 12th post-operative day. Thus, given the excellent post-operative results achieved, surgical treatment in large multi-cavitary benign cardiac tumors is feasible and should be considered a potentially curative therapy.

Case Report: Giant Biatrial Myxoma Mimicking Malignant Cardiac Tumor in a Patient With a Hepatic Angiomatous Mass.

 Cardiac tumors are significantly rare, with pericardial lymphangiohemangioma amongst the rarest cardiac tumor types, with very few reported cases in the literature. Clinically, lymphangiohemangiomas are generally deemed unresectable due to their proximity to the myocardium and the uncertainty of the outcomes following subtotal resection.  Herein, we report a case of a 40-year-old man diagnosed with a pericardial mass, dull thoracodorsal pain, and over a 10-years history of palpitation. Notably, the pericardial mass in the present case was found extended within the myocardium. Thus, a maximal safe resection was deemed preferable to a total resection. The surgically resected specimen showed pathological characteristics of a lymphangiohemangioma. After surgical resection of the lymphangiohemangioma, the patient was free of any tumor-related symptoms. Also, there was no evident tumor progression after a 4-year post-operative follow-up.  To the best of our knowledge, the present case study is the first in the literature to report on a long-term post-operative outcome following subtotal resection of a pericardial lymphangiohemangioma.

Case Report: Long-Term Outcome Following Maximal Partial Resection in a Primary Pericardial Lymphangiohemangioma.

The safety and efficacy of the Cox-Maze IV procedure (CMP-IV) for situs inversus dextrocardia patients with atrial fibrillation is yet to be determined. Herein, we present the case of a 39-year-old male patient admitted to our cardiac center following progressive exertional dyspnea. The patient was diagnosed with situs inversus dextrocardia, severe mitral regurgitation, and paroxysmal atrial fibrillation. A three-dimensional (3D) heart model printing device embedded with designated ablation lines was used for pre-operative planning. Mitral valvuloplasty, CMP-IV, and tricuspid annuloplasty were performed. The patient had an uneventful recovery and was in sinus rhythm during a 12-month follow-up period using a 24-h Holter monitoring device. The case herein is one of the first to report on adopting the CMP-IV procedure for situs inversus dextrocardia patients with complex valvuloplasty operation. In addition, the 3D printing technique enabled us to practice the Cox-maze IV procedure, given the patient's unique cardiac anatomy.

Case Report: The Cox-Maze IV Procedure in the Mirror: The Use of Three-Dimensional Printing for Pre-operative Planning in a Patient With Situs Inversus Dextrocardia.

Cardiac lipomas, though extremely rare, are encapsulated tumors composed primarily of mature fat cells. Despite their benign character, cardiac lipomas can cause life-threatening complications by rapid growth. Cardiac lipomas, which are frequently located in the left ventricle (LV) or right atrium, can originate either from the subendocardium, subpericardium, or the myocardium. They are usually asymptomatic and carry a good prognosis during long-term follow-up; however, published reports show that untreated cardiac lipomas may be fatal when they cause arrhythmic or obstructive symptoms. In addition, several surgical options have been reported to obtain an appropriate operative view following poor visualization, primarily when tumors are located in the LV. Herein, we present a case of a pedunculated LV apical lipoma in a symptomatic patient successfully managed by surgical resection. We also discuss diagnostic modalities in surgical planning and the choice of surgical approach.

Article	Year
Primary leiomyoma: a rare space occupying lesion in the right ventricle. The Annals of thoracic surgery\| PubMed ID: 24384185	2014
MicroRNA Regulatory Network Revealing the Mechanism of Inflammation in Atrial Fibrillation. Medical science monitor : international medical journal of experimental and clinical research\| PubMed ID: 26567235	2015
[Application of cryoablation in  minimally invasive mitral valve surgery]. Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences\| PubMed ID: 27033794	2016
Left atrial appendage aneurysm. Interactive cardiovascular and thoracic surgery\| PubMed ID: 31773142	2020
Surgical Management of a Giant Left Sinus of Valsalva Aneurysm with Coronary Artery Abnormality. The heart surgery forum\| PubMed ID: 33798042	2021
Case Report: Giant Biatrial Myxoma Mimicking Malignant Cardiac Tumor in a Patient With a Hepatic Angiomatous Mass. Frontiers in cardiovascular medicine\| PubMed ID: 34124204	2021
Case Report: Long-Term Outcome Following Maximal Partial Resection in a Primary Pericardial Lymphangiohemangioma. Frontiers in cardiovascular medicine\| PubMed ID: 34368258	2021
Case Report: The Cox-Maze IV Procedure in the Mirror: The Use of Three-Dimensional Printing for Pre-operative Planning in a Patient With Situs Inversus Dextrocardia. Frontiers in cardiovascular medicine\| PubMed ID: 34595222	2021
Surgical Management for a Rare Pedunculated Left Ventricular Apical Lipoma: A Case Report and Review of Literature. Frontiers in cardiovascular medicine\| PubMed ID: 34957231	2021

Long Song

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