Successful surgical resection of infected left atrial myxoma in a case complicated with disseminated intravascular coagulation and multiple cerebral infarctions: case report

We present here the successful surgical treatment of a case of infected left atrial myxoma with septic shock, DIC and cerebral infarction without hemorrahage. Collective review of 58 reported cases with infected cardiac myxoma revealed that surgical treatment for it were still challenging and its result was poor. Until date, only one successful surgical treatment for a case complicated by DIC and cerebral infarctions has been reported, and our report describes second such case of successful resection. Even though this report is limited to a case, only aggressive and prompt surgical intervention could relieve the intractable conditions in such a patient with extremely high risk.Cardiac myxoma is the most common primary cardiac tumour, but infected cardiac myxoma is relatively rare. To the best of our knowledge, 57 previous cases of infected cardiac myxoma have been reported in the English literature [1-6]. Infected cardiac myxoma almost always causes systemic bacteremia, which easily leads to septic shock, disseminated intravascular coagulation (DIC), multiple organ failure. Infected cardiac myxoma is also very fragile and often occurs with systemic embolism including a cerebral infarction, and hence, surgical resection of the tumor is mandatory for the relief of this intractable condition. However, both DIC and cerebral infarction have a high risk for the open heart surgery with systemic heparinization. In this report, we describe a case of infected left atrial myxoma with DIC and multiple cerebral infarctions, who underwent successful surgical treatment.A 52-year-old man had fever and was diagnosed with an influenza-B virus infection two weeks before admission to our hospital. Despite receiving treatment for the influenza virus, he did not recover and his temperature was elevated at 40°C. A blood culture was positive for gram-positive coccus, and echocardiography showed a large left atrial tumour, which was considered to be atrial myxoma with mobile vegetation. He