Background: Myxomas are rare cardiac tumors which often present with stroke caused by tumorous or thrombotic emboli. Treatment with intravenous recombinant tissue plasminogen activator (rtPA) and intra-arterial thrombolysis has been described previously but mechanical thrombectomy has not yet been reported, and treatment of myxoma-related ischemic stroke remains a clinical and technical challenge.
Methods: Two patients with ischemic stroke due to cardiac myxoma in which mechanical thrombectomy was performed are presented.
Results: Endovascular thrombectomy after intravenous rtPA (bridging therapy) was safely achieved in both cases, although with different clinical outcomes and degrees of recanalization.
Conclusions: In stroke secondary to cardiac myxoma, mechanical thrombectomy might represent a safe and effective treatment option. The authors suggest the use of histological examination of the clot for diagnosis as its composition may explain the differences in treatment outcome.
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http://dx.doi.org/10.1136/neurintsurg-2012-010343 | DOI Listing |
Medicine (Baltimore)
January 2025
Department of Medical Imaging, Jincheng People's Hospital, Shanxi, China.
Rationale: Thrombus is the most common occupying lesion in the cardiac chambers, it is often distinguished from cardiac neoplastic occupations. Among them, the most common is cardiac myxoma, whose imaging manifestations are often confused with thrombus. However, the 2 types of lesions have different therapeutic strategies and are both potentially high-risk sources of embolism, so early differentiation between intracardiac thrombus and cardiac tumor is essential.
View Article and Find Full Text PDFEur Heart J Cardiovasc Imaging
January 2025
Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, No. 1, Tongdaobeijie, Huimin District, Hohhot, 010050, China.
Radiol Oncol
January 2025
1Department of Cardiology, University Medical Center Ljubljana, Ljubljana, Slovenia.
Background: The differential diagnosis of cardiac myxomas (CM), the most common benign primary cardiac tumors, is broad and a thorough diagnostic workup is required to establish accurate diagnosis prior to surgical resection. Transthoracic echocardiography (TTE) is usually the first imaging modality used for diagnosis of suspected CM. In a single tertiary centre study, we sought to determine the accuracy, sensitivity, and specificity of TTE in the diagnosis of CM and to determine echocardiographic characteristics indicative of CM.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Cardiology Department, Centre hospitalier de l'université de Montréal, Montréal, QC, Canada.
Left atrial myxoma is the most prevalent primary cardiac tumor, known for its high risk of systemic embolization. Although surgical excision remains the standard treatment, options are limited for high-risk patients. This case report introduces a novel approach using transcatheter electrosurgery to address a left atrial myxoma via a transseptal approach in a patient ineligible for conventional surgery due to the heightened risk of intracranial hemorrhage associated with cerebral amyloid angiopathy.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Papillary fibroelastomas (PFEs) followed by cardiac myxomas (CM) are the 2 most common primary benign cardiac tumors. Although typically asymptomatic, they can manifest with nonspecific symptoms such as dyspnea and dizziness or more acute manifestations such as embolic events. We describe an unusual location of a PFE typically seen with a CM.
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