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, Heng Zhang Department of Cardiovascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University , 79 Qingchun Rd., Shangcheng District, Hangzhou 310058 , China Search for other works by this author on: Oxford Academic Xuelian Ao Department of Ultrasound, First Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , China Search for other works by this author on: Oxford Academic Haige Zhao Department of Cardiovascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University , 79 Qingchun Rd., Shangcheng District, Hangzhou 310058 , China Corresponding author. Email: haigezhao@zju.edu.cn Search for other works by this author on: Oxford Academic
European Heart Journal, Volume 45, Issue 22, 7 June 2024, Page 2023, https://doi.org/10.1093/eurheartj/ehae064
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15 February 2024
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Heng Zhang, Xuelian Ao, Haige Zhao, A rare case of haemorrhagic left atrial bouncing ball myxoma, European Heart Journal, Volume 45, Issue 22, 7 June 2024, Page 2023, https://doi.org/10.1093/eurheartj/ehae064
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A 56-year-old male without any history of cardiac or systemic disease was referred for a 6-day history of sudden onset left-sided weakness. The physical examination revealed a low-frequency diastolic heart murmur at the apex. He exhibited grade III left limb muscle strength, and 12-lead ECG revealed a sinus rhythm.
Transoesophageal echocardiography identified a mobile, hom*ogenous, cystic 3.5 × 4 cm mass that was attached to the interatrial septum (Panels A–C). This mass beat with the heart such that it appeared like an intracardial bouncing ball (see Supplementary data online, Movie S1). Computed tomographic angiography (CTA) confirmed the presence of a mobile pedunculated 3.5 × 4 cm left atrial mass attached to the interatrial septum (Panel D). Brain MRI revealed acute cerebral infarction in the right basal ganglion (Panels E and F), while head CTA revealed no anomalies.
The target mass was successfully removed from the left atria via right mini-thoracotomy cardiopulmonary bypass surgery. The excised tumour was fully encapsulated and filled with blood (Panels G and H). Histopathological analyses confirmed the blood-filled nature of the cystic portion while also indicating that the solid portion was consistent with a myxoma (Panel I).
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CARDIOVASCULAR FLASHLIGHT
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