Decaying left atrial myxoma with systemic embolization. indication and specific time of surgery

in the case of a 54 year-old female patient suffering from unspecific signs of illness - loss of weight about 7 kg within a period of 4 months the echocardiographic diagnosis revealed a left-side artial tumor during a general check. A left-heart catheterization was planned for the following day. in the course of this particular morning the patient unexpectedly experienced a cerebral stroke, an ischemia of ail lour extremities and a cardiac ischemia resulting in a circulatory arrest caused by ventricular fibrillation. After a successful resuscitation and circulatory stabilization the patient was transferred to our clinic immediately diagnosed and subsequently operated. With the help of the extracorporal circulation an atrial tumor was extracted and a myocardial revascularization performed after the embolectomia of parts of this tumor from the ramus circumflexus. An intracranial hamatoma occurring a few hours after the surgery had to be relieved by means of an osteoplastic trepanation of the skullcap. The patient survived and was transferred to a center of rehabilitation. This case emphasizes the urgency of an operation after the definite diagnosis of an atrial tumor.