PMC9424664_01
(A) The apical 4-chamber view of transthoracic echocardiography revealed a mass in the RV and a moderately dilated right heart. (B) The parasternal short-axis view of transthoracic echocardiography revealed a solid, poorly mobile mass attached to the apex of the RV. (C) The myocardial perfusion examination suggested moderate to low perfusion. LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
fsurg-09-924366-g001.jpg
PMC9424664_01_fsurg-09-924366-g001.jpg
F1
A mass having a solid, wide base and poor mobility measuring 39 mm x 21 mm was attached to the apex of the RV, causing moderate to severe RV hypokinesis (Figures 1A,B). Myocardial perfusion examination suggested moderate to low perfusion (Figure 1C).
The computed tomography pulmonary angiogram (CTPA) presented extensive emboli and signs of bilateral pulmonary artery stenosis and filling defects, which were indicated by the arrows both in image A and B.
fsurg-09-924366-g002.jpg
PMC9424664_01_fsurg-09-924366-g002.jpg
F2
Subsequently, CTPA revealed extensive bilateral pulmonary emboli in the right pulmonary artery, left lower pulmonary artery and multiple branching arteries (Figure 2).
(A) The right ventricular mass found during the operation. (B) The denuded pulmonary artery intima during surgery.
fsurg-09-924366-g003.jpg
PMC9424664_01_fsurg-09-924366-g003.jpg
F3
The exfoliated pulmonary intima and the RV thrombus are shown in Figure 3.