SATS 2009 Final Program - Scandinavian Association for Thoracic ...

P01:04
RIGHT VENTRICULAR 3-D ARCHITECTURE IS PRESERVED DURING EXPERIMENTALLY INDUCED
RIGHT VENTRICULAR HYPERTROPHY
Nielsen Eva 1 , Smerup Morten 1 , Agger Peter 1 , Frandsen Jesper 1 , Lunkenheimer Paul P. 2 ,
Anderson Rober H. 3 , Hjortdal Vibeke 1 ,
1) Aarhus University Hospital, Skejby, Denmark, 2) University Münster, Germany,
3) University Collage, London, United Kingdom
Introduction
The three-dimensional architecture of the myocytes in the right ventricular (RV) myocardium is a major determinant
of function, but as yet no investigator-independent methods have been used to characterize either the normal
or hypertrophied state. Our aim was to assess and compare, using diffusion tensor MRI (DTMRI), the normal
architecture with the arrangement induced by chronic hypertrophy.
Materials and methods
20 female piglets were randomized into either pulmonary trunk banding or sham operations. RV hypertrophy was
assessed by in vivo cardiovascular MRI after 8 weeks. Hereafter hearts were excised and fixated, and DTMRI was
performed to determine the helical angles of the myocytes aggregated within the walls, and the presence of any
reproducible tracks formed by the aggregated myocytes.
Results
All banded animals developed significant RV hypertrophy, albeit no difference was observed in terms of helical
angles or myocardial pathways between the banded animals and those undergone the sham operation. Helical
angles varied from approximately 70º endocardially to -50º epicardially. Very few tracks were circular, with helical
angles approximating zero. Reproducible patterns of chains of aggregated myocytes were observed in all hearts.
Discussion
The 3D-architecture of the RV is comparable to that found in the LV, although the RV lacks the extensive zone of
circular myocytes found in the mid-portion of the LV walls. These circular tracks were also not observed in the RVs
of banded animals. Without such beneficial architectural remodeling, the porcine RV seems unsuited structurally to
sustain a permanent afterload increase.
P01:05
SURGERY FOR MYXOMA: A 10 YEAR EXPERIENCE
Bondo Jørgensen Louise 1 , Steinbrüchel Daniel A. 1
1) Rigshospitalet, Denmark
Introduction
Myxoma is a benign neoplasm that represents the most common primary tumor of the heart accounting for about
50 % of all benign cardiac tumors. Despite its benign pathology this tumor may cause significant complication and
mortality by affecting blood flow and causing arrhythmias and emboli.
Material/Methods
The records of 35 patients which underwent surgery for cardiac myxoma at Rigshospitalet, Copenhagen, identified
during the period 1998 to 2008 were reviewed. Patients aged ranged from 23 to 90 years (median age 60); women
predominated by a ratio of 1.2:1.
In 29 patients the tumor was located in the “left side” of the heart (left ventricle/atrium), in 7 patients the myxoma
was found in the right atrium/ventricle.
Results
In 8 patients the myxoma was found accidentally, 9 presented with emboli (cerebral or pulmonary), 18 patients were
investigated du to cardiac symptoms. No significant differences with respect to age, gender, BMI or tumor pathology
could be demonstrated in patients presenting with emboli compared to patients with cardiac symptoms. In 6 patients
CABG , valve surgery or MAZE was performed apart from myxoma resection. 30 day mortality was 2/35 (stroke/
acute MI), 3 patients died during a median 4 year follow op.
Conclusion
Although cardiac myxoma is a benign disease, this tumor form must be classified as potentially fatal due to a
risk of embolisation. An embolic event was the initial clinical manifestation.in 25% of the patients. Therefore an
echocardiography should be considered in adults and young adults with cerebral or pulmonary embolism.
68 www.sats2009.org