Myxoma with a Left-to-Left Shunt and Fistula

Jorens, Philippe G.; Heuvel, P. A. Van Den; Cauwelaert, P. A. Van; Parizel, G

doi:10.1378/chest.96.4.945

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…Subsequent coronary angiography found that a feeding artery arising from the coronary artery supplied the tumor, but did not show the above‐mentioned abnormal blood flow detected by TEE. Few researches on the shunting from a coronary artery to the left atrium via a neovascularized myxoma have been reported . The results of our case indicate that TEE is helpful for confirming the neovascularization of myxoma in the left atrium and finding the abnormal blood flow that spurts from the neovascularized myxoma.…”

Section: Discussionmentioning

confidence: 52%

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Neovascularized Myxoma‐Causing Abnormal Blood Flow in the Left Atrium Diagnosed by Transesophageal Echocardiography

2012

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Myxomas are the most common primary cardiac tumor, and neovascularization of cardiac myxoma has been shown in previous case reports. However, it is seldom reported that abnormal blood flow spurted from a neovascularized myxoma into the cardiac chamber. In this unusual case report, we present a left atrial myxoma in a 44-year-old woman with atypical angina. Transesophageal echocardiography (TEE) revealed several small blood streams spurting from the surface of massively vascularized myxoma into the left atrium. Coronary angiography showed a feeding artery which arose from the right coronary artery and supplied the left atrial myxoma, with no evidence of coronary artery stenosis. This case demonstrated that TTE might be helpful for confirming the neovascularization of myxoma in the left atrium and finding the abnormal blood flow that spurts from the neovascularized myxoma. We speculate that the abnormal blood flow spurting from the neovascularized myxoma into the left atrium may have caused a coronary steal phenomenon thus resulting in myocardial ischemia.

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Section: Discussionmentioning

confidence: 52%

“…Few researches on the shunting from a coronary artery to the left atrium via a neovascularized myxoma have been reported. 7,8 The results of our case indicate that TEE is helpful for confirming the neovascularization of myxoma in the left atrium and finding the abnormal blood flow that spurts from the neovascularized myxoma.…”

Section: Discussionmentioning

confidence: 64%

Neovascularized Myxoma‐Causing Abnormal Blood Flow in the Left Atrium Diagnosed by Transesophageal Echocardiography

2012

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The value of coronary angiography in the work-up of atrial myxomas

Omar

2013

Herz

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Atrial myxomas are the most common primary cardiac tumors. They are highly vascular with evidence of neovascularization and a characteristic"tumor blush" in approximately half of the cases. Although the visualization of feeding vessels has several clinical and therapeutic implications, there is still no consensus on the indication of preoperative coronary angiography to assess tumor vascularity except in patients with angina or those older than 40 years to rule out coronary artery disease. Herein, I present a case of an incidentally discovered right atrial mass receiving vascular supply from the right coronary artery. The mass was successfully excised and the diagnosis of cardiac myxoma was confirmed via histopathology. A review of the value of coronary angiography in detecting myxoma neovascularization is provided, which suggests that it can offer additional valuable information that can alter the surgical approach and therefore may be considered prior to myxoma resection.

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