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CARDIOVASCULAR FLASHLIGHT
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doi:10.1093/eurheartj/ehr222
Online publish-ahead-of-print 6 July 2011
Intracardiac blood cyst: rare finding in a complex congenital heart lesion
Andreas Ku¨hn
1
, Christian Schreiber
2
, Gregor Weirich
3
, and Manfred Vogt
1
*
1
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum Mu¨nchen, Technische Universita¨t Mu¨nchen, Munich, Germany;
2
Department
of Cardiovascular Surgery, Deutsches Herzzentrum Mu¨nchen, Technische Universita¨t Mu¨nchen, Munich, Germany; and
3
Institute of Pathology and Pathological Anatomy,
Technische Universita¨t Mu¨nchen, Munich, Germany
*
Corresponding author. Tel:
+49 89 1218 3012, Fax: +49 89 1218 3013, Email:
drvogt@dhm.mhn.de
Intracardiac blood cysts are rare congenital malformations located in the
endocardium of semilunar or atrioventricular valves. Patients are mostly
asymptomatic and diagnosed in the paediatric age, particularly in the
first months. Appearance in adults is extremely rare. We report on a
28-year-old female with a complex congenital heart defect (congenitally
corrected transposition with ventricle septum defect and pulmonary
stenosis). At the age of 3, she had a Rastelli-type operation. Eight
years later, a stenotic conduit to the pulmonary artery (PA) had to be
replaced by a homograft.
On admission, transthoracic echocardiography showed a systolic peak
gradient between the left ventricle and PA of 50 mmHg and an unclear
structure at the basis of the mitral valve (MV). Transoesophageal echocar-
diography demonstrated a cystic liquid tumour attached to the posterior
MV leaflet with a diameter of 1.9 cm (Panel A; Supplementary material
online, Movie 1 and Movie 2). During diastole, the tumour prolapsed
into the MV ostium causing a mean diastolic inflow gradient of 4 mmHg.
This situation did not allow for the initially planned catheter intervention.
Diagnostic catheterization (Panel B) confirmed the echo findings. After
surgical opening of the right atrium (Panel C), a blood filled cystic tumour attached to the posterior MV leaflet was found. Panel D
shows the opened cyst. To our knowledge, only one other case of a de novo formation of a blood cyst after cardiac surgery is reported
in the literature.
Panels: Asterisk indicates blood cyst; arrow, attachment of the blood cyst to the mitral valve; RA, right atrium; LV, left ventricle.
Supplementary material
Supplementary material is available at European Heart Journal online.
Published on behalf of the European Society of Cardiology. All rights reserved.
&
The Author 2011. For permissions please email: journals.permissions@oup.com
Determinants of MRI detected carotid plaque components
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