Eur J Cardiothorac Surg 1998;13:604-605
© 1998 Elsevier Science NL
Images in cardio-thoracic surgery |
Intermittent left-to-right shunt due to a left atrial myxoma
Massimo Massetti,
Gerard Babatasi,
Eric Saloux,
Andre Khayat
Thoracic and Cardiovascular Surgery Department, University Hospital 14033 Caen Cedex, France
Received 4 March 1998;
accepted 9 March 1998.
Corresponding author.
A 65-year-old female patient was admitted to our department for evaluation of a 6-month progressive dyspnea and arrhythmia. Trans-thoracic echocardiography was remarkable for normal ventricular function, but a free-floating mass was detected in the left atrium; its attachment to the septum was clear and during diastole it moved into the mitral valve plane creating an obstruction-like syndrome
Fig. 1
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Fig. 1. Trans-esophageal echocardiogram demonstrating free-floating mass (T) in the left atrium (a) with migration in the mitral valve plane during cardiac cycle. V, left ventricle.
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Trans-esophageal Doppler echocardiography confirmed the left atrial tumor and showed an intermittent left-to-right shunt through the foramen ovale during the cardiac cycle
Fig. 2
. Urgent surgery was planned and a left atrial myxoma was resected under cardiopulmonary bypass and cardioplegic arrest. The tumor, 5 cmx3 cm, was widely attached to the inter-atrial septum in the region of fossa ovale and, during the cardiac cycle, it led to an intermittent re-opening of foramen ovale.
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Fig. 2. Trans-esophageal echocardiogram showing the left to right shunt (S) around the base of attachment of the tumor (T) in the region of fossa ovale.
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