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Ann Thorac Surg 1998;65:835-837
© 1998 The Society of Thoracic Surgeons

Case Reports

Obstructive Rhabdomyoma and Univentricular Physiology: A Rare Combination

Umesh Dyamenahalli, MD, Michael D. Black, MD, Christine Boutin, MD, Robert M. Gow, MB, BS, Robert M. Freedom, MD

Division of Cardiovascular Surgery, The Hospital for Sick Children and The University of Toronto, Toronto, Ontario, Canada
Division of Cardiology, The Hospital for Sick Children and The University of Toronto, Toronto, Ontario, Canada

Accepted for publication October 16, 1997.

Dr Black, Division of Cardiovascular Surgery, The Hospital for Sick Children, 555 University Ave., Toronto, ON, Canada M5G 1X8 (e-mail: michael.black@mailhub.sickkids.on.ca).

We report the successful excision of a large left atrial rhabdomyoma producing complete obstruction of both inflow and outflow to the left ventricle. Systemic perfusion was dependent on anterograde ductual flow. The resultant univentricular physiology was initially managed medically, with spontaneous tumor regression contemplated as a means of possible long-term "cure." Failure to achieve hemodynamic stability compelled urgent surgical excision. This neonate was successfully discharged home with an in-series biventricular circulation.






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