Features of the Blood Supply of Cardiac Myxoma which Can Cause Bleeding

With a mortality rate of 1 % to 5 %, surgical treatment cardiac myxomas (CM) may be complicated by the development intra- or postoperative bleeding, among other things.
 The aim. To present an unusual case left atrial myxoma with occurrence intraoperative which was due extremely rare features coronary circulation special blood supply base CM.
 Case report. Female patient R., 65 years old, record No.3686, admitted National Amosov Institute Cardiovascular Surgery Academy Medical Sciences Ukraine diagnosis CM. Coronary angiography revealed unique circulation: arteriovenous malformation from distal parts circumflex branch artery discharge into right heart revealed. On 9/20/2022, urgent operation resection atrium (LA) performed. After removal and sealing heart, accumulation arterial found in area inferior vena cava (IVC) interatrialsulcus. Revision cavity performed again:all intracardiac sutures were duplicated. repeated resealing chambers, bleeding IVC region stopped after administration protamine sulfate tight tamponade space under IVC. Tampons removed pericardial 72 hours.
 Results. source could site arteries, is tangle small vessels located projection below point where meets atrium. During histological examination myxoma, large full-blood sinusoidal type revealed, around which, damage their thin walls, hematomas formed, giving tumor spotted appearance. peculiarity this presence very vascular plexus at its base; it had appearance cluster sections numerous, different-sized, deformed remodeled arteries. These data confirmed angiography.
 Conclusions. Studying analysis offeatures localization as well possible malformations, can provide information that allows predicting possibility damage, especially place manipulation. In event one optimal methods elimination use long-term tamponade.