Doctors at the Meshalkin National Medical Research Center repaired a congenital defect that had compressed a 46-year-old patient’s heart.
Surgeons at the Meshalkin National Medical Research Center in Novosibirsk operated on a 46-year-old woman from Russia’s Altai Republic who had a rare congenital vascular abnormality. The center said a structure about 12 centimeters across had been compressing her heart and disrupting coronary blood flow.
The woman sought care after experiencing shortness of breath and an irregular heartbeat. Tests showed that the structure, which doctors described as a “ball,” was filled with blood. The center’s radiologists said it was diverting blood from the coronary circulation and could rupture, posing a potentially fatal risk.
Because the patient’s superior vena cava was blocked, doctors connected a heart-lung machine through vessels in her thigh and neck. They then stopped her heart and opened the aneurysm from the enlarged opening of a coronary artery. The operation was described by cardiac surgeon Alexander Bogachev-Prokofiev, director of the center’s Institute of Circulatory Pathology.
During surgery, doctors identified a large vascular malformation, a congenital defect that creates an abnormal connection between arterial and venous blood flow. Such malformations are usually tangled clusters of small vessels. In this case, the center said, blood flowed directly from the left side of the heart to the right through a branch of a coronary artery.
The surgeons closed the abnormal connection with a patch and repaired the coronary artery. They also treated atrial fibrillation. The clinic said the long-standing rhythm disorder was unlikely to resolve on its own even after pressure on the left atrium had been removed.
The center said the patient was being discharged with a normal heart rhythm and without the threat of further coronary artery disease. Doctors estimate the unusual anatomy developed over more than 20 years. The center said it had not previously encountered a malformation of this size and location in its practice, and that only isolated cases had been mentioned in international medical literature.