Koji Akasu

Left ventricular myxoma: report of a case.

Abstract Although recent advances in echocardiography have made it easier to detect cardiac tumors, left ventricular myxomas are still rare and often not found until the patient presents with a history of syncopal episodes or systemic embolization. Left ventricular myxomas are usually benign and curable; however, unreliable excision of the myxoma due to poor visualization of the left ventricular cavity can result in recurrence. To prevent recurrence, it is necessary to select the most appropriate surgical approach to excise the myxoma completely. We report herein the case of a patient in whom surgical excision of a left ventricular myxoma arising from the posterior wall of the left ventricle was successfully performed.

Percutaneous cardiopulmonary support for treatment of massive pulmonary embolism

Abstract The management of massive pulmonary embolism remains difficult, particularly when cardiogenic shock is involved. In an attempt to rescue and maintain the preoperative circulatory condition, seven patients with acute pulmonary embolism were given percutaneous cardiopulmonary support (PCPS). The circulation, respiratory condition, and urinary output were all improved after PCPS induction. Two patients died of profound cardiogenic shock before the operation. Five patients underwent surgical embolectomy. Postoperatively, all patients who underwent embolectomy were continuously assisted with PCPS. The overall survival rate after PCPS induction was 42.9% (3/7), and the success rate of surgical embolectomy was 60% (3/5). One of the major complications associated with PCPS was bleeding, which can be associated with preoperative thrombolysis. The use of PCPS immediately resuscitated and stabilized the hemodynamic condition and allowed a successful emergency pulmonary embolectomy to be performed. Additionally, PCPS was effective for postoperative respiratory management, which is sometimes associated with reperfusion pulmonary edema.