Spontaneous implantation of a left atrial myxoma into the left ventricle (RCD code: VI‑1A.1)

Diana Stettner-Leonkiewicz, Andrzej Tomaszewski, Andrzej Wysokiński, Janusz Stążka, Marek Czajkowski, Michał Tomaszewski

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Abstract


Myxomas are one of the most common cardiac tumors. In 70–80% of cases they are located in the left atrium, 10–20% in the right atrium and in less than 10% in ventricles. We report a case of a 60-year-old patient after myocardial infarction of the posterior-inferior-lateral wall and subsequent percutaneous coronary interventions, who presented with symptoms of unstable angina. Based on standard criteria including cardiac enzymes acute coronary syndrome was excluded. Transthoracic echocardiogram showed hypokinesis of the lateral wall, normal left ventricular ejection fraction of 56%, left ventricular hypertrophy, enlarged heart chambers and moderate mitral regurgitation. Additional two masses were visualized -  one of 3.1 x 1.4 cm size growing from interatrial septum in the area of fossa ovalis in the left atrium, second of 1.2 x 0.4 cm connected to the chordae tendinae in the left ventricle. On transthoracic echocardiography a distal part of the left atrial structure spontaneously fell into the left ventricle hitting the tendinae. Successful surgical removal of both masses followed by pathological evaluation confirmed the diagnosis of myxomas.

Keywords


rare disease; cardiac tumor; echocardiography; coronary artery disease; mitral regurgitation; mitral valve repair; coronary artery bypass graft; intra‑aortic balloon pump

References


Silverman NA. Primary cardiac tumors. Ann Surg 1980; 191: 127–138.

McAllister HA, Fenoglio JJ Jr. Tumors of the cardiovascular system. Atlas of tumor pathology. 2nd series. Fascicle 15. Armed Forces Institute of Pathology, Washington DC 1978.

King TW. On the simple vascular growths in the left auricle of the heart. Lancet 1845; 2: 428–429.

Effert S, Domaning E. The diagnosis of intracranial and thrombi by the ultrasonic echo method. German Med Mth 1959; 4: 1.

Chitwood WR. Clarence Crafoord and the first successful resection of a cardiac myxoma. Ann Thorac Sur. 1992; 54: 997–998.

Jones DR, Warden HE, Murray GF et. al. Biatrial approach to cardiac myxomas: A 30-year clinical experience. Ann Thorac Surg 1995; 59: 851–856.

Poole GV, Meredith JW, Breyer RV et. al. Surgical implantations in malignant cardiac disease. Ann Thorac Surg 1983; 36: 484–491.

Reece IJ, Cooley DA, Frazier OH et. al. Cardiac tumors: Clinical spectrum and prognosis of lesions other than classical benign myxoma in 20 patients. J Thorac Cardiovasc Surg 1984; 88: 439–446.

Jones DR, Warden HE, Murray GF et. al. Biatrial approach to cardiac myxoma: A 30-year clinical experience. Ann Thorac Surg 1995; 59: 851–856.

Tsukamoto S, Shiono M, Orime Y et. al. Surgical treatment of 22 cardiac myxomas: A review. Ann Thorac Cardiovasc Surg 1999; 5: 146–149. 11. Johanson L. Histogenesis of cardiac myxomas. Arch Patol Lab Med 1989; 113: 735–741.

Farrell DJ, Bulmer E, Angus B et al. Immunohistochemical expression of endothelial markers in left atrial myxoma: a study of six cases. Histopathology 1996; 28: 147–152.

Reynen K. Medical progress: Cardiac myxomas. N Engl. J Med 1995; 333: 1610–1617.

Graford C. Discussion of Glover R.P. Late results of mitral commissurotomy. In: Lam C.R. ed. Henry Ford Hospital international symposium on cardiovascular surgery; studies in physiology, diagnosis and techniques; proceedings of the symposium. March 1995. Henry Ford Hospital, Detroit, Michigan. W.I.B. Saunders, Philadelphia 1955; 202–211.

Rydlewska-Sadowska W, Szwed H. Śluzaki serca II – obraz echokardiograficzny [Cardiac myxomas II – an echocardiographic image]. Kardiol Pol 1986; 29: 12–25.

Effert S, Domaning E. The diagnosis of intracranial tumors and thrombi by the ultrasonic echo method. German Med Mth 1959; 4: 1.

Premarante S, Hasaniya N, Arakaki H et al. Atrial myxomas: experiences with 35 patients in Hawaii. Am J Surg 1995; 169: 600–603.

Greenwood WF. Profile of atrial myxoma. Am J Cardiol 1968; 21: 367–375.




DOI: http://dx.doi.org/10.20418%2Fjrcd.vol2no7.227

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