PURPOSE Although primary cardiac tumors are rare, cardiac myxoma is the most common seen intracardiac tumor. This study summarizes our surgical experience with cardiac myxomas. METHODS Twenty-eight cases of cardiac myxoma that were surgically treated in our center between January 1990 and March 2010 were retrospectively reviewed. In all patients the New York Heart Association (NYHA) functional classification was used to assess the functional status, and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were measured before and after surgery. RESULTS Nineteen patients were female and 9 male. The mean age was 53.3 ± 12.7 years (range 4-73). The most common symptom was dyspnea (86%). Two patients presented with peripheral embolism. In preoperative assessment of functional status, 24 of the patients were in NYHA Class II, 2 of them were in Class I and the other 2 patients were in Class III. All patients were in NYHA class I in the early postoperative period up to long-term follow up. The mean preoperative CRP and ESR levels were 47.3 ± 14.6 mg/l (range 30-79) and 52.8 ± 21.4 mm/h (range 28-82), respectively. One month after surgery, CRP and ESR levels returned back to normal values. Postoperative CRP and ESR levels were 8.4 ± 2.6 mg/l (range 1-12) and 7.9 ± 4.8 mm/h (range 3-18), respectively. CONCLUSION Myxomas should be considered in all patients with embolism. After surgical resection of cardiac myxomas, the functional status of patients improve and CRP and ESR levels become normal.

Vascular complications in orthopedic surgery are not frequent, but they can be severe and occasionally limb-threatening. While spontaneous complications are not directly dependent on the surgical procedure, iatrogenic complications are those actively caused by surgical maneuvers or by instrumentation. Although vascular injury during placement of a cerclage wire is feared by all surgeons, its occurrence is rare and we have been able to find only one reported case describing an injury to the femoral artery and vein. This case report describes the surgical management of occlusions of the popliteal artery and vein following a cerclage wiring procedure of the distal femur during a total knee replacement procedure. Surgical treatment was accomplished by resection of the entrapped artery and vein segments and reattachment with end to end anastomosis. The orthopedic surgeon must be aware of prevalent risk of vascular injury during knee surgery and be diligent and methodological about performing preoperative and postoperative vascular examination in these patients.