Asian Cardiovasc Thorac Ann 2007;15:78
© 2007 Asia Publishing EXchange Ltd
IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY |
Large Pedunculated Left Atrial Myxoma
Vahe Gasparyan, MD,
Tigran Hakobyan, MD,
Vanik Galstyan, MD,
Arthur Hairapetyan, MD
Department of Cardiac Surgery, Erebouni Medical Center, Yerevan, Armenia
For reprint information contact: Vahe Gasparyan, MD Tel: 374 9154 1411 Fax: 374 1045 8287 Email: vahegasparyan{at}yahoo.com, Department of Cardiac Surgery, Erebouni Medical Center, 14 Titogradian St., 375087 Yerevan, Armenia.
A 44-year-old male presented to Erebouni Medical Center emergency department with two days of respiratory insufficiency. On physical examination, the positive finding was a grade II pre-systolic murmur at the apex. Electrocardiography showed atrial fibrillation with the ventricular rate of 94 beat· min–1. Transthoracic 2-dimensional echocardiography in apical 4-chamber view revealed a large pedunculated mass attached to the interatrial septum (Figure 1
). The atrial mass protruded into the mitral valve (Figure 2). The patient underwent excision of the myxoma. Bi-caval cardiopulmonary bypass was instituted with 32 °C cooling followed by antegrate cold blood cardioplegic solution. The tumor was exscised using biatrial approach and sent for histology (Figure 3). A sufficient amount of atrial septum was excised to include the tumor attachment and uninvolved tissue about 5 mm beyond it. The tumor was considered to be a cardiac myxoma. We present the images of the large pedunculated myxoma.
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Figure 1. Transthoracic 2-dimensional echocardiogram in apical 4-chamber view showing a large pedunculated mass in the left atrium attached to the interatrial septum with the pedicle measuring 6.6 mm.
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Figure 2. Transthoracic 2-dimensional echocardiogram in apical 4-chamber view showing a large pedunculated mass in the left atrium fixed to the interatrial septum, measuring 72.7 x 39.8 mm and protruded into the mitral valve.
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Figure 3. Large pedunculated left atrial myxoma measuring 5 x 7 cm with the attachment area of interatrial septum.
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