REVIEW   

Italian Journal of Vascular and Endovascular Surgery 2017 June;24(2):70-5

DOI: 10.23736/S1824-4777.17.01289-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Huge pedunculated left atrial myxoma with mitral valve replacement due to annular dilatation and concomitant coronary artery disease: a literature review

Daniel C. IROEGBU ✉, Zhou ZHONGXIN

Department of Thoracic and Cardiovascular Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

Atrial myxomas are the most common primary tumors of the heart. The majority of them are benign with left atrial myxoma being the most frequent one. Once diagnosed, surgical resection is the basic clinical approach and standard of care. Atrial myxomas commonly grow on the interatrial septum with the fossa ovalis been the most common site. However, it might also originate from the atrial appendage, posterior and anterior atrial wall. They can be pedunculated (stalk) or sessile, with the former been the most common type. Patients with atrial myxoma could be symptomatic or asymptomatic on presenting with varying clinical features depending on its location and other pathologies. Triads of symptoms mostly encountered are valvular obstruction, embolic events and constitutional symptoms. These might also lead to life threatening complications such as acute heart failure, stroke and even sudden death. Clinical symptoms may suggest the presence of myxoma, but echocardiography is the mainstay of diagnosis and confirmation is by histopathology. The aim of this review literature was to discuss the current knowledge so far in clinical practice about the natural history of the tumor, mitral regurgitation due to dilatation of the annulus caused by the pendulum-like motion effects of the tumor on the annular ring, and also to take a look at concomitant coronary artery diseases with the possible likelihood of embolization using cardiac computed tomography, echocardiographic reports, explaining its role and effectiveness in the diagnosis of left atrial myxomas (is it a tumor or a thrombus?).

KEY WORDS: Myocardial infarction - Myxoma - Cardiac imaging techniques - Echocardiography - Embolism - Mitral valve insufficiency