A Case of Myonephropathic Metabolic Syndrome Caused by Aortic Saddle Embolus Originating from a Left Atrial Myxoma

Abstract

A 69-year-old woman presented with sudden onset severe lower limb ischemia. A huge embolus originating from a left atrial myxoma had completely occluded the aorta and bilateral common iliac artery. Emergency operation was performed and a left atrial myxoma was extirpated through a superior transseptal approach on cardiopulmonary bypass (CPB). CPB was continued for the purpose of preventing shock after reperfusion of the limb and a saddle embolus of the aorta and bilateral common iliac artery was removed 10 hours after the onset of limb ischemia. Myonephropathic metabolic syndrome (MNMS) occured and required continuous hemodiafiltration (CHDF), but she fully recovered after 48 days of CHDF and hemodiafiltration (HDF) postoperatively. The dilution ultrafiltration method (DUF) during operation and early CHDF were effective for therapy of MNMS.