Narain Moorjani

Intravenous Uterine Leiomyosarcomatosis With Intracardial Extension

Abstract  Uterine leiomyosarcoma is a rare malignant tumor of smooth muscle origin. We describe the case of a 64‐year‐old female with intravenous uterine leiomyosarcomatosis with the extension of the tumor mass into the inferior vena cava and right atrium. As initial tissue diagnosis of the tumor obtained from the uterine and right atrial masses suggested intravenous leiomyomatosis, surgical resection was carried out using a one‐stage procedure via a laparotomy and median sternotomy with cardiopulmonary bypass and circulatory arrest. Subsequent histology revealed uterine leiomyosarcoma with an intravenous spread, which to our knowledge is only the second case that has been described.

Prolonged survival with left atrial spindle cell sarcoma

Primary spindle cell sarcoma of the left atrium is a rare tumour. Optimal treatment is to obtain complete surgical clearance of the tumour. The anatomic location of the tumour, infiltration into vital structures and difficult access provides a surgical challenge for resection of the lesion and reconstruction of the defect. The prognosis of patients with a primary cardiac sarcoma is very poor because of their resistance to treatment with chemotherapy and radiotherapy. Metastases and local recurrences are common despite optimal multimodality treatment. This report describes a 48-year-old gentleman who underwent multiple surgeries to achieve an 11-year survival since the diagnosis. The operative techniques have been described.

Pericardial synovial sarcoma.

Abstract  Synovial sarcomas of the pericardium are very rare. This report describes the case of a 61‐year‐old man presenting with increasing dyspnea on exertion and recurrent pericardial effusions. Echocardiography, computed tomography, and magnetic resonance imaging demonstrated a 6 × 4‐cm pericardial mass lying predominantly over the left atrium. He was treated by surgical excision with the aid of cardiopulmonary bypass, and a subsequent histological analysis confirmed the diagnosis of a pericardial synovial sarcoma.

Right ventricular blood cyst causing outflow tract obstruction in an adult.

Abstract  Blood cysts are benign intracardiac masses that are well described in infants. We present a rare adult presentation of a blood cyst tethered to the right ventricular wall and the tricuspid valve causing right ventricular outflow obstruction. Multimodality imaging approach was found to be of great importance in the diagnosis and treatment of this patient. (J Card Surg 2012;27:452‐454)

Extra-anatomic aorto-femoral graft for acute limb ischemia after type a aortic dissection repair.

Abstract  We report an alternative approach to revascularization of the leg in a patient with acute type A aortic dissection, where other options were not feasible. An aorto‐femoral extra‐anatomic conduit was used to salvage the leg after major aortic surgery where further surgery or endovascular grafting would have lead to increased morbidity. (J Card Surg 2011;26:397‐399)

Rare complication of bioprosthetic aortic valve replacement

CE-Perimount aortic bioprosthesis in a 59-year-old-man, implanted 8 years ago, showed non-infective severe structural deterioration. Preoperative echocardiogram demonstrated a prolapsing cusp (Fig. 1(A—C)); however, intra-operative echocardiogram and findings revealed a ‘missing’ leaflet (Figs. 1(D), 2(A and B) and Video 1). www.elsevier.com/locate/ejcts European Journal of Cardio-thoracic Surgery 39 (2011) e82