{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:19:05Z","timestamp":1774613945112,"version":"3.50.1"},"reference-count":7,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Left atrial myxoma is the most common benign primary cardiac tumor and is associated with embolic and hemodynamic complications. Complete surgical excision is the treatment of choice, while postoperative cardiovascular rehabilitation is essential for functional recovery. Case Presentation: We report the case of a 75-year-old woman with arterial hypertension, dyslipidemia, and chronic venous insufficiency (Clinical\u2013Etiological\u2013Anatomical\u2013Pathophysiological (CEAP) class 2), and chronic hepatitis B virus (HBV) infection who underwent surgical excision of a left atrial myxoma and was subsequently admitted three weeks postoperatively for phase II cardiovascular rehabilitation. The postoperative course was complicated by transient atrial fibrillation, peripheral edema, pleural effusion, and progressive purpuric lesions of the lower limbs. Laboratory and immunological evaluation revealed positive cryoglobulins, markedly elevated rheumatoid factor (1058 UI\/mL) and IgM levels (715 mg\/dL), reduced complement levels (C3, C4), normocytic normochromic anemia, microscopic hematuria, and elevated ALT (156 U\/L), AST (142 U\/L), total bilirubin (1.4 mg\/dL), and INR (1.6), suggestive of hepatic inflammatory activity. HBV status was scheduled for evaluation through Gastroenterology referral (HBV DNA viral load, serological markers: HBsAg, HBeAg, anti-HBe), as our Cardiology Rehabilitation Clinic lacks the possibility of evaluation. After systematic exclusion of alternative etiologies, secondary cryoglobulinemic vasculitis in the context of chronic HBV infection with biochemical evidence of hepatic activity was considered the most plausible diagnosis. Conclusions: This case highlights the complexity of managing elderly patients after cardiac tumor surgery, particularly in the presence of systemic comorbidities. Early recognition of extracardiac complications and an individualized, multidisciplinary strategy are essential to optimize outcomes.<\/jats:p>","DOI":"10.3390\/reports9020101","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:12:25Z","timestamp":1774609945000},"page":"101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Atrial Myxoma Surgery in Cryoglobulinemic Vasculitis Associated with Hepatitis B: A Clinical Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2036-9303","authenticated-orcid":false,"given":"Iustina Maria","family":"Andrie\u0219","sequence":"first","affiliation":[{"name":"Grigore T. Popa University of Medicineand Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6406-6573","authenticated-orcid":false,"given":"Radu Sebastian","family":"Gavril","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicineand Pharmacy, 700115 Iasi, Romania"},{"name":"Romanian Academy of Medical Sciences, 927180 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-3320","authenticated-orcid":false,"given":"Cristina Andreea","family":"Adam","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicineand Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1755-9674","authenticated-orcid":false,"given":"Grigore","family":"Tinica","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicineand Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1801-9327","authenticated-orcid":false,"given":"Florin","family":"Mitu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicineand Pharmacy, 700115 Iasi, Romania"},{"name":"Romanian Academy of Medical Sciences, 927180 Bucharest, Romania"},{"name":"Romanian Academy of Scientists, 050044 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1056\/NEJM199512143332407","article-title":"Cardiac Myxomas","volume":"333","author":"Reynen","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"107940","DOI":"10.1016\/j.ejso.2023.107940","article-title":"Clinical Characteristics and Surgical Outcomes of Cardiac Myxoma: A Meta-Analysis of Worldwide Experience","volume":"50","author":"Oktaviono","year":"2024","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Jakuskaite, G., Jakuska, P., Benetis, R., Vaskelyte, J.J., and Ereminiene, E. (2025). Diagnosis and Surgical Treatment Outcomes of Cardiac Myxoma: Twenty Years of Data at a Single Institution. Medicina, 61.","DOI":"10.3390\/medicina61112025"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Mendyka, D., P\u0142onek, T., J\u0119drasek, T., Korman, A., Z\u0142otowska, A., J\u0119drasek, A., Skalik, R., and Kustrzycki, W. (2025). The Therapeutic Potential of Different Surgical Approaches in the Management of Cardiac Myxoma: A Systematic Review. J. Clin. Med., 14.","DOI":"10.3390\/jcm14010121"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1186\/s13019-024-03333-2","article-title":"Cardiac Myxoma: A Comprehensive Review","volume":"20","author":"Okongwu","year":"2025","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Mazzaro, C., Dal Maso, L., Gragnani, L., Visentini, M., Saccardo, F., Filippini, D., Andreone, P., Zignego, A.L., Gattei, V., and Monti, G. (2021). Hepatitis B Virus-Related Cryoglobulinemic Vasculitis: Review of the Literature and Long-Term Follow-Up Analysis of 18 Patients Treated with Nucleos(t)ide Analogues from the Italian Study Group of Cryoglobulinemia (GISC). Viruses, 13.","DOI":"10.3390\/v13061032"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Mazzaro, C., Adinolfi, L.E., Pozzato, G., Nevola, R., Zanier, A., Serraino, D., Andreone, P., Fenoglio, R., Sciascia, S., and Gattei, V. (2022). Extrahepatic Manifestations of Chronic HBV Infection and the Role of Antiviral Therapy. J. Clin. Med., 11.","DOI":"10.3390\/jcm11216247"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/101\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:35:12Z","timestamp":1774611312000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":7,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["reports9020101"],"URL":"https:\/\/doi.org\/10.3390\/reports9020101","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]}}}