Cardiac myxoma shedding leads to lower extremity arterial embolism: A case report

Observation of the effect of angiojet to treat acute lower extremity arterial embolization

BACKGROUND

Through significant advances in the treatment of peripheral arterial occlusive disease, acute ischemia of the lower extremity is still associated with significant morbidity, limb threat and mortality. The two main causes of acute ischemia in lower extremities are arterial embolism and atherosclerotic arteries. Timely recognition and treatment of acute limb ischemia in emergency situations is essential in order to minimize the duration of ischemia.

AIM

To investigate the application effect of angiojet thrombolysis in the treatment of acute lower extremity arterial embolization.

METHODS

Sixty-two patients with acute lower extremity arterial embolization admitted to our hospital from May 2018 to May 2020 were selected. Among them, the observation group (twenty-eight cases) had received angiojet thrombolysis, and the control group (thirty-four cases) had received femoral artery incision and thrombectomy. After thrombus clearance, significant residual stenosis of the lumen was combined with balloon dilation and/or stent implantation. When the thrombus removal was not satisfactory, catheter-directed thrombolysis was performed. The incidence of postoperative complications, recurrence rate and recovery of the two groups were compared.

RESULTS

There were no significant differences in postoperative recurrence (target vessel reconstruction rate), anklebrachial index and the incidence of postoperative complications between the two groups (P > 0.05); there were statistically significant differences in postoperative pain score and postoperative rehabilitation between the two groups (P < 0.05).

CONCLUSION

The application of angiojet in the treatment of acute lower limb artery thromboembolism disease is safe and effective, minimally invasive, quicker recovery after operation, less postoperative complications, which is more suitable for the treatment of femoral popliteal arterial thromboembolism lesions. If the thrombus removal is not satisfactory, the combination of coronary artery aspiration catheter and catheterized directed thrombolysis can be used. Balloon dilation and stent implantation can be considered for obvious lumen stenosis.

Case of Dilated Cardiomyopathy in Combination with Left Atrial Myxoma and Left Atriomegaly (Rare Clinical Case)

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.