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European Journal of Echocardiography Advance Access originally published online on June 13, 2009
European Journal of Echocardiography 2009 10(7):876-879; doi:10.1093/ejechocard/jep080
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Lipomatous hypertrophy of the interatrial septum: report of two cases where histological examination and surgical intervention were unavoidable

Rita Calé1,*, Maria João Andrade1, Manuel Canada1, Rafael Hernandez-Estefania2, Sónia Lima1, Miguel Abecasis3, Emília Vitorino4, Rosa Gouveia4, Raquel Gouveia1 and José Aniceto Silva1

1 Cardiology Department, Centro Hospitalar de Lisboa Ocidental (CHLO), Portugal
2 Department of Cardiovascular Surgery, Policlinica Gipuzkoa, San Sebastian, Spain
3 Department of Cardiothoracic Surgery, Centro Hospitalar de Lisboa Ocidental (CHLO), Portugal
4 Department of Pathology, Centro Hospitalar de Lisboa Ocidental (CHLO), Portugal

Received 27 March 2009; accepted after revision 16 May 2009; online publish-ahead-of-print 13 June 2009.

* Corresponding author. Tel: +35 196 555 8968. E-mail address: ritacale{at}hotmail.com


  Abstract

Lipomatous hypertrophy of the interatrial septum (LHIS) is an increasingly recognized heart condition characterized by fatty deposits in the interatrial septum with sparing of the fossa ovalis. Its distinctive characteristic features by imaging techniques, benign nature, and the fact that most patients remain asymptomatic, has limited the need for histological confirmation and operative intervention in most cases. In this report, we describe two cases of LHIS where cardiac surgical intervention was indispensable: in the first patient, due to the presence of an additional left atrial tumour found out as mixoma and in the second, to relief a superior vena cava obstruction together with bypass grafts for severe coronary artery disease. Histological samples of the interatrial septal lesion were obtained in both cases either because of uncertainty of the diagnosis (Case 1) or to confirm the diagnosis (Case 2).

Keywords: Lipomatous hypertrophy of the interatrial septum; Cardiac tumours; Transesophageal echocardiography; Vena cava obstruction


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