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Randomized controlled trial of monopolar cautery versus clips for staple line bleeding control in Roux-en-Y gastric bypass
(Elsevıer scıence bv, po box 211, 1000 ae amsterdam, netherlands, 2018) Gündoğan, Ersin; Kayaalp, Cüneyt; Aktaş, Aydın; Sağlam, Kutay; Sansal, Müfit; Uylas, Ufuk; Gökler, Cihan; Çiçek, Egemen; Sümer, Fatih
Background: Bleeding from the staple line is a rare but serious problem following bariatric surgery. Staple line bleeding control (SLBC) can be achieved in different ways such as the application of sutures, clips, glue or buttressing materials over the staple line. Cauterization alone is generally not preferred due to concerns about debilitating the staple line. Objectives: The aim of this study was to compare the clip and monopolar cauterization methods for SLBC in laparoscopic Roux-en-Y gastric bypass. Setting: University hospital. Methods: A total of 70 morbidly obese patients were randomized into two groups. Patients with previous upper gastrointestinal surgery, re-do procedures and open surgeries were excluded. Their demographic characteristics, intraoperative and postoperative outcomes were examined. Results: A total of 489 SLBC interventions (274 clips and 215 cauterizations) were performed after 280 stapling applications. SLBC intervention number and location, additional trocar requirement, blood loss and operation time were not different between the groups. In the clip group, two patients required monopolar cauterization when clipping failed. No intraabdominal bleeding or gastrointestinal leakage was seen in any group. Postoperative gastrointestinal hemorrhage was seen in three patients, two in the clip group and one in the cautery group. There was no difference between the groups in terms of postoperative pain score, abdominal drainage amount, hemoglobin level alteration, morbidity or length of stay. Conclusions: In laparoscopic Roux-en-Y gastric bypass, monopolar cauterization for SLBC can be used instead of clipping. It appears that monopolar cautery is a safe and effective approach for SLBC in laparoscopic Roux-en-Y gastric bypass.
Right axilloaxillary cannulation for surgical management of a giant ascending aortic aneurysm
(Wıley, 111 rıver st, hoboken 07030-5774, nj usa, 2018) Battaloğlu, Bektaş; Akça, Barış; Erdil, Nevzat; Çolak, Cengiz
Is there any difference in risk factors between male and female patients in new-onset atrialfibrillation after coronary artery bypass grafting?
(Georg thıeme verlag kg, rudıgerstr 14, d-70469 stuttgart, germany, 2018) Akca, Baris; Erdil, Nevzat; Colak, Mehmet Cengiz; Disli, Olcay Murat; Battaloglu, Bektas; Colak, Cemil
Background We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. Methods This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study. The female patients were divided into two groups as patients who developed new-onset AF after CABG and those who did not. The relationship between the patients' variables and risk factors of post-CABG AF was examined. Results The overall incidence of post CABG AF was 12.9% (386/2,836). Sex-specific incidence of AF was similar: 3.2% (91/690) and 12.9% (277/2146) in female and male patients, respectively (p = 0.849). Multiple analysis revealed the independent risk factors for male and female patients, respectively: mean age (odds ratio [OR] = 1.057, OR = 1,076), age over 65 years (OR = 2.156, OR = 2.736), the European System For Cardiac Operative Risk Evaluation Scores (EuroSCORE) (OR = 1.13, OR = 1.218), COPD (OR = 1.589, OR = 1.789), BUN level (OR = 1.026, OR = 1.019), mean cardiopulmonary bypass (CPB) time (OR = 1.007, OR = 1.010), prolonged CPB time (OR = 1.604, OR = 2.309), mean cross-clamp time (OR = 1.009, OR = 1.017), need of inotropic support (OR = 2.249, OR = 2.731), and mean mechanical ventilation time (VT) (OR = 1.026, OR = 1.027). Low left ventricular ejection fraction (LVEF) (OR = 1.419), left ventricular (LV) aneurysm repair (OR = 1.533), carotid artery disease (OR = 1.750), prolonged VT (OR = 1.729), and use of intra-aortic balloon pump (IABP) (OR = 2.436) were found to be the risk factors only for male AF patients. Unstable angina (OR = 1.969), right coronary artery (RCA) disease (OR = 2), prolonged cross-clamp time (OR = 2.152), and the number of grafts per operation (OR = 1.298) were found to be the risk factors only for female AF patients. Conclusion This study suggests that predictors of AF in the overall population may be due to isolated patient groups. Multiple regression analysis and artificial intelligence modelling should be performed on large-scale, isolated groups to make strong AF prediction.
Protective effect of resveratrol against renal oxidative stress in cholestasi
(Ren Fail. 2005;27(4):435-40., 2005) Ara, Cengiz; Karabulut, Aysun Bay; Çoban, Sacid; Uğraş, Murat Yahya; Kırımlıoğlu, Vedat; Yılmaz, Sezai
BACKGROUND/AIMS: This experimental study was designed to evaluate histological changes of the kidney and renal tissue levels of malondialdehyde (MDA), reduced glutathione (GSH), and nitric oxide (NO) and the effect of resveratrol on these metabolites after bile duct ligation in rats. METHODS: Secondary biliary cirrhosis was induced by bile duct ligation for 28 days. Swiss albino rats were divided into three groups. Group 1: Sham (n=7), Group 2: Bile duct ligation (n=7), Group 3: Bile duct ligation plus resveratrol (n=7). Bile duct ligation (BDL) plus resveratrol group received 10 mgr/kg dose of resveratrol intraperitoneally daily throughout 28 days. Kidney tissues were harvested to determine the tissue levels of MDA, GSH, and NO activity. Liver and kidney tissues were removed for light microscopic evaluation. RESULTS: Cholestasis was determined by biochemical and pathologic examination. In the resveratrol-treated rats, levels of MDA were significantly lower than those of the BDL group (p < 0.04). The levels of GSH in the resveratrol-treated rats were significantly higher than those in the BDL group (p < 0.01). The levels of NO in the resveratrol group were significantly lower than those in the BDL group (p < 0.01). CONCLUSION: The present study demonstrates that intraperitoneal administration of resveratrol in bile duct ligated rats maintains antioxidant defenses and reduces kidney oxidative damage. This effect of resveratrol may be useful in the preservation of renal oxidative stress in cholestasis.
Protective effect of aminoguanidine against oxidative stress in an experimental peritoneal adhesion model in rats
(Cell Biochem Funct. 2006 Sep-Oct;24(5):443-8., 2006) Ara, Cengiz; Karabulut, Aysun Bay; Kırımlıoğlu, Hale; Yılmaz, Mehmet; Yılmaz, Sezai
Postoperative intraperitoneal adhesion formation is a major cause of intestinal obstruction, pain and infertility. This experimental study was designed to evaluate the degree of adhesion formation and peritoneal tissue levels of malondialdehyde (MDA), reduced glutathione (GSH) and total nitrite and nitrate (NO) and the effect of aminoguanidine (AG) on these metabolite values after postoperative intraperitoneal adhesion formation in rats. A total of 21 adult male Wistar albino rats were randomly divided into three groups. Control rats were untreated; the AG group received AG 200 mg kg(-1) i.p. for 10 consecutive days intraperitoneally after surgery. The sham group was given 0.9% NaCl. The rats were killed on postoperative day 10. The peritoneal tissues were harvested to determine the tissue levels of MDA, GSH, and NO activity. For light microscopic evaluation, the cecum was removed. Adhesion formation scores in the AG group were significantly lower than those of the control and sham groups (p < 0.017, p < 0.026 respectively). In the AG-treated rats, tissue levels of MDA and NO were significantly lower than in the control group (p < 0.017). The levels of GSH in aminoguanidine-treated rats were significantly higher than those of the control group (p < 0.01). The severity of the inflammation was more prominent in the control group compared with the AG-injected rats. The results demonstrate that in this experimental model, intraperitoneal administration of aminoguanidine decreases the incidence and extent of peritoneal adhesions and causes a decrease in MDA and NO and an increase in GSH values.
Aorto pulmonary artery fistula an unusual complication of ascending aortic aneurysm
(Annals of Thoracic Surg, 1992) Taşdemir, Oğuz; Vural, Kerem; Santaş, Ahmet; Battaloğlu, Bektaş; Bayazıt, Kemal
We report an unusual outcome of an ascending aorta aneurysm ruptured into the main pulmonary trunk. After successful emergency repair, an acute respiratory distress syndrome developed perioperatively and complicated the postoperative period. The patient could not be weaned from mechanical ventilation for a long time. The patient was discharged on the 62nd day of admission in good condition.
Surgical treatment of cardiac echinococcosis Report of ten cases
(Assian Cardiovascular and Thorac Ann, 1995) Sarıtaş, Ahmet; Yamak, Birol; Şener, Erol; Birincioğlu, Levent; Battaloğlu, Bektaş; Mavitaş, Binali; Taşdemir, Oğuz; Bayazıt, Kemal
Routine coronary arteriography before abdominal aortic aneurysm repair
(American Journal of Surgery, 1995) Bayazıt, Murat; Göl, Kamil; Battaloğlu, Bektaş; Tokmakoğlu, Hilmi; Taşdemir, Oğuz; Bayazıt, Kemal
BACKGROUND AND AIMS OF THE STUDY: It is commonly held that preservation of the annulo-ventricular continuity during mitral valve replacement has a beneficial effect on postoperative ventricular function. This paper presents our eight-year experience with this technique. MATERIALS AND METHODS: From 1986 to December 1992, 120 patients with rheumatic valve disease underwent mitral valve replacement (MVR) combined with preservation of the posterior leaflet of the mitral valve. The mean age was 33.87 years (range 16 to 63). The preoperative New York Heart Association (NYHA) class was III in 64% of the patients and IV in 3%. The early (30 day) mortality rate was 2.5% (3/120). Follow up was 100% complete. The total cumulative follow up was 477 patient-years (pty) with a mean 3.94 years (range: 2-8 years). RESULTS: The actuarial survival rate (including hospital mortality) was 87.6% at eight years. Advanced age (p = 0.0457), increased preoperative functional capacity (p = 0.0251), increased preoperative end-systolic diameter (p = 0.0352) and combined tricuspid reconstruction (p = 0.0001) were found to be independent parameters for a lower actuarial survival rate. Six patients (1.25%/pty) developed thromboembolic complications. Two of these were cerebrovascular accidents (0.41%/pty) and four were caused by mechanical valve thrombosis (1.83%/pty). Freedom from thromboembolic complications (including mechanical valve thrombosis) was 89.8% +/- 7.9%. Fifteen patients (3.14%/pty) developed valve failure, four (0.83%/pty) mechanical valve thrombosis and nine (1.88%/pty) bioprosthetic valve failure. Freedom from reoperation was 60.7% +/- 16.1%. One patient with a St. Jude Medical valve (0.2%/pty) suffered from prosthetic valve endocarditis. Three patients (0.62%/pty) died during the follow up period, and, freedom from all valve related complications was 51.4% +/- 16.1% at eight years. CONCLUSION: Preservation of the posterior leaflet during mitral valve replacement reduces the risk of early mortality and did not cause additional complications to the patients. Despite the beneficial effects of this technique in the long term this technique did not increase the long term survival in patients with associated impaired valvular and/or ventricular function.
Minimaly ınvasive coronary artery bypass grafting the rib cage lifting thecnique
(J Thorac Cardiovasc Surg, 116, 354-6 (1998)., 1998) Haldun, Karagöz; Kurtoğlu, Murat; Özerdem, Gökhan; Battaloğlu, Bektaş; Korkmaz, Şule; Bayazıt, Kemal
Minimally ınvasive replacement of ascending aortic aneurysms ıntermediate term results
(The Heart Surgery Forum, 1999) Battaloğlu, Bektaş
BACKGROUND: Minimally invasive techniques have gained recent interest in the realm of cardiac surgery. This report describes our initial experience with graft replacement of ascending aortic aneurysms using a superior mini-sternotomy approach. METHODS: Between March 1997 and October 1997, four patients underwent operation for ascending aortic aneurysm via superior mini-sternotomy approach. There were two female and two male patients, ranging in age from 52 to 62 years (mean 53.7 +/- 7.6). All patients had the stigmata of Marfan's syndrome. Mean diameter of the ascending aortas was 6.1 +/- 0.9 cm. Composite graft replacement with coronary reimplantation was performed in all cases. In one patient hemiarch replacement was performed under total circulatory arrest. There was no hospital (30-day) mortality. Mean aortic cross clamp and cardiopulmonary bypass times were 63 +/- 14.1 minutes (range 44 to 78) and 116.7 +/- 43.3 minutes (range 81 to 177), respectively. One patient was re-explored for bleeding. RESULTS: Lengths of hospital stay ranged from 5 to 7 days (mean 5.5 +/- 1). Patients were followed-up for at least 18 months. One patient suffered a fatal stroke in her third postoperative month. All surviving patients were in NYHA Class I at the sixth postoperative month and thereafter. CONCLUSIONS: Minimally invasive graft replacement of ascending aortic aneurysms can be performed safely and effectively. Long term results are likely to be similar to those of conventional cases performed through a full median sternotomy.
Coronary artery bypass grafting in a patient with double spiral spontaneous coronary artery dissection
(Case Rep Clin Pract Rev, 2002) Battaloğlu, Bektaş; Erdil, Nevzat; Koşar, Feridun
Background: Spontaneous coronary artery dissection is a rare cause of myocardial ischemia. It is a condition with greater prevalence in young women, particularly in the peripartum or early postpartum period. Case report: We report a case of double spontaneous spiral coronary artery dissections involving the left anterior descending and right coronary artery in a 39-year-old man who underwent successful coronary artery bypass grafting. Conclusion: Early diagnosis is imperative for survival. Coronary artery bypass grafting is a safe and reliable method for spontaneous multiple spiral dissections of coronary arteries which present with myocardial ischemia.
Does cardiopulmonary bypass alter plasma level of tumor markers ca 125 and carcinoembryonic antigen
(The Thoracic and Cardiovascular Surgeon, 2002) Battaloğlu, Bektaş; Erdil, Nevzat; Nisanoğlu, Vedat; Koşar, Feridun; Özgür, Bülent; Yıldırım, Bülent; Karagöz, Hüseyin
BACKGROUND: In addition to malignant diseases, acute and chronic inflammations may elevate plasma levels of tumor markers CA 125 and carcinoembryonic antigen (CEA). Cardiopulmonary bypass (CPB) causes a generalized inflammatory response. In this study, we have investigated the effect of CPB on plasma levels of CA 125 and CEA. METHODS: We measured plasma levels of CA 125 and CEA in patients undergoing coronary artery bypass grafting (CABG) with CPB (Group 1, n = 21), and in patients who underwent off-pump CABG, that is, without CPB (Group 2, n = 16). Blood samples were collected preoperatively, and on postoperative days 1, 6, and 12. RESULTS: Within both groups, CEA plasma levels were not significantly influenced in any samples. Comparing with preoperative values, CA 125 values elevated significantly on postoperative days 6 and 12 within both groups. It was observed that the elevation of CA 125 plasma levels in these samples were significantly higher in Group 1. CONCLUSIONS: The results indicate that CPB elevated plasma level of CA 125. However, clinical importance of this finding needed further evaluation.
Identification of viable myocardium in patients with chronic coronary artery disease and myocardial dysfunction comparison of low dose dobutamine stress echocardiography and echocardiography during glucose insulin potassium infusion Angiology
(Angiology, 2002) Yetkin, Ertan; Şenen, Kubilay; İleri, Mehmet; Atak, Ramazan; Battaloğlu, Bektaş; Yetkin, Özkan; Tandoğan, İzzet; Turhan, Hasan; Cehreli, Sengül
Low-dose dobutamine stress echocardiography (LDDSE) is one of the methods most used to assess myocardial viability. Glucose-insulin-potassium (GIK) has been shown to increase contraction of the ischemic zone. The aim of this study was to compare LDDSE and echocardiography during GIK infusion for detection of myocardial viability in patients with chronic coronary artery disease (CAD) and myocardial dysfunction. Twenty-one patients who had chronic CAD and myocardial dysfunction were included in the study. Glucose-insulin-potassium protocol consisted of a fixed dose of insulin (100 μU/kg/hour IV) and a variable glucose/potassium infusion rate. GIK echocardiography was made at baseline and after 60 minutes of GIK infusion. During continuous electrocardiographic, blood pressure, and echocardiographic monitoring, an intravenous infusion of dobutamine (3 μg/kg body weight/min) was started with an infusion pump and continued for 5 minutes and then increased to 5 μg/kg/min and 10 μg/kg/min for another 5 minutes. The detected viable myocardium was defined as 1 or 2 scores decreasing in at least 2 adjacent abnormal segments during LDDSE and GIK echocardiography. Viability was detected in 19% (52 segments) of the asynergic segments at baseline with GIK echocardiography and 16% (44 segments) of those segments with LDDSE (p > 0.05). Left ventricular wall motion score index at baseline was 2.24 ±0.35 and it decreased significantly during both LDDSE (p = 0.004 vs 2.11 ±0.36) and GIK echocardiography (p=0.001 vs 2.09 ±0.32). The agreement between LDDSE and GIK echocardiography for detection of myocardial viability was 95%. This study shows that GIK echocardiography is similar to LDDSE for detection of myocardial viability. With the support of further clinical studies GIK echocardiography can be used to detect myocardial viability in patients with chronic CAD.
Increased thrombolysis in myocardial infarction frame counts in patients with isolated coronary artery ectasia
(Heart Vessels, 2003) Senen, Kubilay; Yetkin, Ertan; Turhan, Hasan; Atak, Ramazan; Sivri, Nasir; Battaloğlu, Bektaş; Tandoğan, İzzet; İleri, Mehmet; Koşar, Feridun; Özdemir, Ramazan; Cehreli, Şengül
The Thrombolysis in myocardial infarction (TIMI) frame count is a simple clinical tool for assessing quantitative indexes of coronary blood flow. This measurement has been significantly correlated with flow velocity measured with a flow-wire by several investigators during baseline conditions or hyperemia. In this study we aimed to evaluate the coronary flow in patients with isolated coronary artery ectasia by means of the TIMI frame count and to compare the results with those of patients with angiographically normal coronary arteries. The study population consisted of 37 patients with coronary artery ectasia only in the right coronary artery (RCA). The control group consisted of 31 patients with angiographically proven normal coronary arteries. Coronary artery ectasia was defined as nonobstructive lesions of the coronary arteries with a luminal dilatation 1.5-fold or more of the adjacent normal coronary segments. The TIMI frame count was determined for each major coronary artery in each patient according to the methods first described by Gibson et al. The TIMI frame count of RCA in the study group was significantly higher than in that of the control group (51 17 vs 25 8, P 0.0001). The TIMI frame counts of the study group for the left anterior descending and left circumflex coronary artery were also significantly higher than those of the control group (corrected TIMI frame count for LAD 42 11 vs 24 7, P 0.001; TIMI frame count for LCx 44 15 vs 25 9, P 0.001). In patients with coronary artery ectasia, the TIMI frame count of the RCA was higher than that of the left anterior descending and left circumflex coronary artery (51 17 vs 42 11 and 44 15, respectively, P 0.05). We have shown increased TIMI frame counts in patients with isolated coronary artery ectasia and suggest that the pathophysiological mechanism of coronary artery ectasia is not a focal disease. TIMI frame counts can be regarded as an index of the severity of impaired coronary flow in patients with coronary artery ectasia.
Arterial myocardial revascularization using bilateral radial artery 17years after right pneumonectomy
(Texas Heart Instıtute Journal, 2004) Erdil, Nevzat; Nisanoğlu, Vedat; Toprak, Hüseyin İlksen; Erdil, Feray Akgül; Kuzucu, Akın; Battaloğlu, Bektaş
fter coronary artery bypass grafting (CABG), patients with a previous pneumonectomy are predisposed to a substantial risk of cardiopulmonary complications. The best surgical strategy for performing CABG on After patient with a single lung is unclear from the literature;1 few such cases have been reported.1-4 To our knowledge, this is the 1st report of arterial myocardial revascularization with use of bilateral radial arteries and fast-track anesthesia in a patient with a previous pneumonectomy
Acute abdominal aorta embolism caused by rupture of a cardiac hydatid cyst
(Annals of Vascular Surgery, 2004) Nisanoğlu, Vedat; Erdil, Nevzat; Işık, Burak; Battaloğlu, Bektaş; Alat, İlker
We report a case of an abdominal aortic embolism due to rupture of a cardiac hydatid cyst. This report emphasizes the diagnostic, preventative, and treatment options for hydatid cyst embolism of abdominal aorta. Echocardiography should be routinely performed in all patients with hydatid disease for possible involvement of the heart. This enables early diagnosis and treatment of cardiac echinococcus before life-threatening complications occur.
Urgent revascularization of a liver allograft with a saphenous vein interposition graft between the hepatic artery and the recipient splenic artery after late hepatic artery thrombosis
(Digestive Diseases and Sciences, 2005) Yılmaz, Sezai; Kıvrımoğlu, Vedat; Işık, Burak; Yılmaz, Mehmet; Kıvrımoğlu,Hale S.; Ara, Cengiz; Söğütlü, Gökhan; Battaloğlu, Bektaş
Hepatic artery thrombosis (HAT) after liver transplantation is a severe complication which may lead to graft infarction and subsequent graft loss. It complicates 2–12% of adult liver transplantations (1, 2) and subsequently leads to retransplantation in 50–75% of patients (3). Fortunately, innovations in Doppler ultrasonography and digital angiography technologies have provided an accurate and rapid method for detecting HAT before ischemic damage of the allograft (4). Revascularization procedures that can be performed once the diagnosis of HAT has been confirmed include thrombectomy alone, intrahepatic arterial thrombolysis with thrombolytic agents, creation of a new anastomosis between a more proximal part of the recipient artery and a more distal part of the donor hepatic artery, and introduction of an interposition graft (3). Early diagnosis is a prerequisite for these revascularization strategies.
Effect of posterior pericardiotomy on early and late pericardial effusion after valve replacement
(Journal of Cardiac Surgery, 2005) Nisanoğlu, Vedat; Erdil, Nevzat; Battaloğlu, Bektaş; Koşar, Feridun; Erdil, Feray Akgül; Cihan, H. Berat
Pericardial effusion (PE) after cardiac surgery is frequent. It is more frequently seenafter valve replacement or other types of heart surgery. Oral anticoagulants and antiplatelet agents mayinduce effusion development after open heart surgery. Our objective was to determine the efficiency ofposterior pericardiotomy (PP) after cardiac valve operation for reducing the incidence of early and late PEand tamponade.Methods: This prospective randomized study was carried out in 100 consecutive patientsundergoing mechanical valve replacement between August 2001 and May 2003 in our institution. Patientswere divided into two groups; each group consisted of 50 patients. Longitudinal incision was made paralleland posterior to the left phrenic nerve, extending from the left inferior pulmonary vein to the diaphragm inGroup 1. Posterior pericardiotomy was not done in Group 2.Results: Early PE was detected in four patients(8%) and in 19 patients (38%) in Group 1 and Group 2, respectively (p < 0.001). No late PE effusion wasdeveloped in Group 1 despite nine (18%) late PE developing in Group 2 (p < 0.003). The rate of delayedpericardial tamponade was lower in Group 1, but this difference was not statistically significant (0% vs 10%;p < 0.056).Conclusion: These findings suggest that PP is an easy, feasible, and beneficial technique forreducing both the occurrence of early and late PE or pericardial tamponade in patients undergoing valvereplacement.
Complete left sided absence of the pericardium in association withbuptured type A aortic dissection complicated by severe left hemothorax
(Texas Heart Instıtute Journal, 2005) Nisanoğlu, Vedat; Erdil, Nevzat; Battaloğlu, Bektaş
We report an unusual clinical presentation of an acute type A aortic dissection as a left hemothorax in a patient with a congenital pericardial defect. Although the pericardial defect was diagnosed preoperatively, we could not exclude the possibility of a ruptured descending aorta until we discovered the site of the rupture during operation. The presence of a pericardial defect would at first appear to be a fatal disadvantage in such a situation as this, due to massive bleeding into the pleural space; but we believe that in our patient spontaneous drainage of blood into the pleural cavity prevented severe cardiac tamponade. The only reason for his deteriorating hemodynamic status was hypovolemia, which was corrected with volume replacement. (Tex Heart Inst J 2005;32: 241-3)
A case of left atrial myxoma associated with atrial septal defect
(Journal of Cardiac Surgery, 2005) Koşar, Feridun; Erdil, Nevzat; Güllü, Hakan; Şahin, İbrahim; Nisanoğlu, Vedat; Battaloğlu, Bektaş
Cardiac myxoma is the most frequent primary tumor of the heart. However, it is rarely associ-ated with congenital cardiac anomalies such as atrial septal defect in the literature. We present a 72-year-oldwoman referred to the emergency department with loss of consciousness and finally diagnosed as a ped-inculated mobile left atrial myxoma and concomitant occurrence of an ostium secundum type atrial septaldefect. The mass was successfully excised, and atrial septal defect was safely repaired by primary suture.The patient is currently well after surgery. Atrial myxoma should be considered in the differential diagno-sis when patients present with neurological consequences of systemic embolization.

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