Case Presentation
A 63-year-old male patient was admitted to the local hospital for acute left heart failure after field operations. He suffered from severe hypoxemia along with cardiogenic shock. He was intubated 12 hours after treatment with diuresis, cardiotonic, vasodilator, and ventilation. When our team arrived on day 2, his blood pressure was maintained at 80/50 mmHg with high-dose inotropic support (noradrenaline [100 ug/min], pituitrin [2U/h], and dobutamine [20 ug/kg.min]), and his PaO2/FiO2 (P/F) ratio was only 80 mmHg. It is worth noting that his blood pressure considerably fluctuated with heart rate. A bed-side echocardiography showed a giant anomalous vegetation bearing a strong resemblance to the evil eye (Figure. 1). He was put on veno-arteriovenous extracorporeal membrane oxygenation (VAV-ECMO) for progressive cardiopulmonary failure and was transferred to our intensive care unit (ICU) 4 hours later.
On day 3, surgery was performed through the right atrium and atrial septum, and revealed a 75 × 30mm mass attached by a narrow stalk (10 mm) originating from the atrial septum (Figure. 2). ECMO was suspended for 60 minutes during cardiopulmonary bypass and was removed 2 days later. On day 10, the patient was discharged from the ICU in good condition and was doing well on outpatient follow-up.