Saddle Embolus as First Presentation of Left Atrial Myxoma in a 14-Year-Old Girl

Wj, Leach; Jg, Pollock

doi:10.1177/003693308803300513

Cited by 5 publications

(2 citation statements)

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“…Data from the literature usually present sporadic cases of peripheral myxomatous embolism with very good results of surgical treatment of ischemia, as well as the removal of a heart tumor. 31,32…”

Section: Discussionmentioning

confidence: 99%

Rare Forms of Peripheral Arterial Embolism: Review of 11 Cases

Davidović

Mikic

et al. 2005

Vascular

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The purpose of this study was to present 11 patients operated on owing to rare forms of peripheral arterial embolism at the Institute for Cardiovascular Diseases of the Serbian Clinical Center over a period of 20 years. Three patients were operated on owing to a foreign body embolism, two owing to a septic embolism, three owing to emboli that originated from malignant tissues, two owing to an embolization from cardiac myxoma, and one owing to an embolism from a myxomatous atrial septal defect. The preoperative evaluation included clinical examination, laboratory findings, and electrocardiography; in the majority of cases, ultrasonography and angiography were performed. Surgical treatment included foreign body extraction in three cases; thromboembolectomy in seven cases, and artery resection and saphenous graft interposition in one patient with septic embolism. In addition, three cardiosurgical procedures were done: aortic valve replacement in the patient with a septic embolism and tumor excision in patients with atrial myxoma. In addition to the usual clinical signs of acute limb ischemia, in the rare forms of arterial embolism, the presence of certain uncommon clinical symptoms was also observed. The early results of vascular surgical treatment were very good in all patients. Further follow-up revealed a poor prognosis in patients with malignant arterial embolism.

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Section: Discussionmentioning

confidence: 99%

Rare Forms of Peripheral Arterial Embolism: Review of 11 Cases

Davidović

Mikic

et al. 2005

Vascular

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“…3 Five cases of myxomatous saddle emboli of the aorta presenting with acute lower limb ischemia have been reported in the literature, none of which were complicated by reperfusion injuries. [4][5][6] Fascial decompression in patients with compartment syndrome is of proven benefit in reducing amputation and mortality following revascularization. 7,8 In the past, hyperkalemia caused by reperfusion has been treated by primary lower limb amputation 9 and emergency femoral vein ligation to prevent potentially fatal rises in potassium despite aggressive dextrose, insulin, and bicarbonate regimens.…”

Section: Discussionmentioning

confidence: 99%

Complications of Reperfusion in Acute Aortic Artery Occlusion Following Saddle Embolization Originating from an Atrial Myxoma

Ali

Castro²,

Young³

et al. 2004

Vascular

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A 58-year-old man presented to the hospital with an 8-hour history of acute-onset bilateral lower limb ischemia. A large saddle embolus had occluded the aorta and could not be removed by balloon endarterectomy through the femoral arteries. Successful open aortic and femoral thromboembolectomy followed by extensive fasciotomies was accompanied by severe reperfusion injury. Life-threatening hyperkalemia was associated with three episodes of intraoperative ventricular fibrillation and ventricular tachycardia requiring cardiac massage and defibrillation. A dextrose-insulin-bicarbonate infusion was required to correct the hyperkalemia. Rhabdomyolysis developed at 24 hours, causing marked myoglobinuria and acute renal failure, which required hemofiltration. Histology of the recovered embolus confirmed an atrial myxoma, and when the patient had fully recovered, open cardiac surgery was carried out to resect the tiny stump of residual myxoma. Rhabdomyolysis associated with a myxomatous saddle embolus has not been previously reported. This case highlights the need for pre- and perioperative measures to be taken to overcome hyperkalemia and acute renal failure when revascularizing acute, massive, prolonged ischemia of the lower body.

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The Causes of Finger Clubbing: A List Worth Learning

Jamieson

2011

The American Journal of Medicine

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Saddle Embolus as First Presentation of Left Atrial Myxoma in a 14-Year-Old Girl

Cited by 5 publications

References 1 publication

Rare Forms of Peripheral Arterial Embolism: Review of 11 Cases

Rare Forms of Peripheral Arterial Embolism: Review of 11 Cases

Complications of Reperfusion in Acute Aortic Artery Occlusion Following Saddle Embolization Originating from an Atrial Myxoma

The Causes of Finger Clubbing: A List Worth Learning

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