PMC5467278_01
Right atrium vegetation in different view in echocardiography subcostal; four chamber views during systole and diastole. Note mobile position of mass that enters RV during diastole. Last image showed four chamber views after mass resection.
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Echocardiography finding includes the following: mild right and left ventricle enlargement, mild tricuspid valve regurgitation, mild mitral valve regurgitation, LV ejection fraction = 50%, and RA mass of 2.5 and 3 cm, mobile and attached to tricuspid leaflet in lower border (Figure 1).
Thickening and inflammation of pericardium.
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During the operation after the midsternotomy, the pericardium was thickened and there was adhision to the heart (Figure 2). On cardiopulmonary by-pass and on pump beating heart, after opening RA, there was a lesion in 2 x 2.5 x 3 cm (Figure 2) attached to anterior tricuspid valve (Figure 3).
Intracardiac vegetation: one in the tricuspid valve and another in the entrance of SVC to right atrium.
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On cardiopulmonary by-pass and on pump beating heart, after opening RA, there was a lesion in 2 x 2.5 x 3 cm (Figure 2) attached to anterior tricuspid valve (Figure 3).
The complete excision of intracardiac mass (vegetation).
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The mass was shaved completely from tricuspid valve and another mass was found near entrance of superior vena cava to right atrium that was resected completely (Figure 4).